Provider Demographics
NPI:1164589958
Name:MOORE, CYNTHIA SUE (RN CFNP)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:SUE
Last Name:MOORE
Suffix:
Gender:F
Credentials:RN CFNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:324 CHICHESTER LN
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26104-8513
Mailing Address - Country:US
Mailing Address - Phone:304-464-5284
Mailing Address - Fax:304-422-7374
Practice Address - Street 1:911 EMERSON AVE
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26104-2526
Practice Address - Country:US
Practice Address - Phone:304-422-7357
Practice Address - Fax:304-422-7374
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV35438363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily