Provider Demographics
NPI:1164011698
Name:SAFO-MENSA, CYNTHIA ANDOH (CRNP FAMILY)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ANDOH
Last Name:SAFO-MENSA
Suffix:
Gender:F
Credentials:CRNP FAMILY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13706 MANED GOOSE LN
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-7124
Mailing Address - Country:US
Mailing Address - Phone:301-503-4902
Mailing Address - Fax:
Practice Address - Street 1:8101 SANDY SPRING RD
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-3596
Practice Address - Country:US
Practice Address - Phone:301-363-9233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-11
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR150112363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily