Provider Demographics
NPI:1093312324
Name:AKIN, CYNTHIA ANN (NP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ANN
Last Name:AKIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:ANN
Other - Last Name:AKIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2532 REFLECTIONS PL
Mailing Address - Street 2:
Mailing Address - City:WEST MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-6673
Mailing Address - Country:US
Mailing Address - Phone:321-591-5023
Mailing Address - Fax:
Practice Address - Street 1:2532 REFLECTIONS PL
Practice Address - Street 2:
Practice Address - City:WEST MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32904-6673
Practice Address - Country:US
Practice Address - Phone:321-591-5023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-09
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11009428363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner