Provider Demographics
NPI:1164959680
Name:SUPLINSKI, CYNTHIA L (APNP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:L
Last Name:SUPLINSKI
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:L
Other - Last Name:HEIDENREICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APNP
Mailing Address - Street 1:PO BOX 22487
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54305-2487
Mailing Address - Country:US
Mailing Address - Phone:920-445-7226
Mailing Address - Fax:920-445-7229
Practice Address - Street 1:704 S WEBSTER AVE
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-3528
Practice Address - Country:US
Practice Address - Phone:920-433-7984
Practice Address - Fax:920-445-7289
Is Sole Proprietor?:No
Enumeration Date:2017-05-15
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3710-33363L00000X, 364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner