Provider Demographics
NPI:1114335494
Name:EHRET, UN CINDY KIM
Entity Type:Individual
Prefix:MRS
First Name:UN CINDY
Middle Name:KIM
Last Name:EHRET
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CINDY UN
Other - Middle Name:KIM
Other - Last Name:EHRET
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5920 WATER MARK DR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-9587
Mailing Address - Country:US
Mailing Address - Phone:404-310-7721
Mailing Address - Fax:
Practice Address - Street 1:5920 WATER MARK DR
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-9587
Practice Address - Country:US
Practice Address - Phone:404-310-7721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-30
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMAA2014-005367H00000X
GA8817367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant