Provider Demographics
NPI:1164612610
Name:FOLLROD, CINTHIA EDWARDS (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:CINTHIA
Middle Name:EDWARDS
Last Name:FOLLROD
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:MS
Other - First Name:CINTHIA
Other - Middle Name:EDWARDS
Other - Last Name:FLETCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPNP
Mailing Address - Street 1:1327 ROBESON ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28305-5531
Mailing Address - Country:US
Mailing Address - Phone:910-486-5437
Mailing Address - Fax:910-486-0011
Practice Address - Street 1:1327 ROBESON ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-5531
Practice Address - Country:US
Practice Address - Phone:910-486-5437
Practice Address - Fax:910-486-0011
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC300292364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
300292OtherLICENSE NUMBER
NC59-06387Medicaid