Provider Demographics
NPI:1093958589
Name:ELLIOTT, CYNTHIA MOTE (DNP, FNPC)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:MOTE
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:DNP, FNPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5825 N JIMSON LN
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85743-8899
Mailing Address - Country:US
Mailing Address - Phone:520-869-1232
Mailing Address - Fax:
Practice Address - Street 1:1151 E HERMANS RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85756-9367
Practice Address - Country:US
Practice Address - Phone:520-794-8353
Practice Address - Fax:520-794-7353
Is Sole Proprietor?:No
Enumeration Date:2009-04-13
Last Update Date:2024-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3310363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ526013Medicaid
AZ431655Medicaid
AZZ137338Medicare UPIN
AZ431655Medicaid
AZZ131101Medicare UPIN