Provider Demographics
NPI:1164712840
Name:LENDBORG, CYNTHIA DIANN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:DIANN
Last Name:LENDBORG
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15801 W APACHE ST
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-9400
Mailing Address - Country:US
Mailing Address - Phone:602-707-2715
Mailing Address - Fax:602-707-2740
Practice Address - Street 1:1209 E INDIAN SCHOOL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-4925
Practice Address - Country:US
Practice Address - Phone:602-707-2700
Practice Address - Fax:602-707-2740
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-14
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLP042563164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse