Provider Demographics
NPI:1144803784
Name:TERREBONNE, CINDA CAY
Entity Type:Individual
Prefix:
First Name:CINDA
Middle Name:CAY
Last Name:TERREBONNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 E PASS RD STE 1
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39507-3212
Mailing Address - Country:US
Mailing Address - Phone:228-731-3313
Mailing Address - Fax:228-731-3313
Practice Address - Street 1:450 E PASS RD STE 1
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39507-3212
Practice Address - Country:US
Practice Address - Phone:228-731-3313
Practice Address - Fax:833-346-0381
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-02
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
MS1262455332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies