Provider Demographics
NPI:1164709366
Name:PESCHONG, CYNTHIA A (ARNP, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:A
Last Name:PESCHONG
Suffix:
Gender:F
Credentials:ARNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 SHEA CENTER DR STE 450
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2255
Mailing Address - Country:US
Mailing Address - Phone:303-225-0025
Mailing Address - Fax:303-225-0029
Practice Address - Street 1:10103 RIDGEGATE PKWY STE G23
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5524
Practice Address - Country:US
Practice Address - Phone:303-225-0025
Practice Address - Fax:303-225-0029
Is Sole Proprietor?:No
Enumeration Date:2011-11-16
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARXN.0000831-C.NP363LF0000X
FLARNP9170645363LF0000X
COAPN.0001860-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004351400Medicaid