Provider Demographics
NPI:1164918546
Name:DAVIS, CYNTHIA ANN (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ANN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:FNP-C
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Mailing Address - Street 1:251 SALINA MEADOWS PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13212-4516
Mailing Address - Country:US
Mailing Address - Phone:315-464-2000
Mailing Address - Fax:315-464-2010
Practice Address - Street 1:90 PRESIDENTIAL PLAZA
Practice Address - Street 2:3RD FL
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202
Practice Address - Country:US
Practice Address - Phone:315-464-4357
Practice Address - Fax:315-464-2030
Is Sole Proprietor?:No
Enumeration Date:2018-07-09
Last Update Date:2020-01-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY343278363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05245143Medicaid