Provider Demographics
NPI:1174197354
Name:CYPRESS, EBONY YVETTE (CNA)
Entity Type:Individual
Prefix:
First Name:EBONY
Middle Name:YVETTE
Last Name:CYPRESS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:893 BELVOIR CIR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23608-7734
Mailing Address - Country:US
Mailing Address - Phone:757-594-5116
Mailing Address - Fax:
Practice Address - Street 1:893 BELVOIR CIR
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23608-7734
Practice Address - Country:US
Practice Address - Phone:757-594-5116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-13
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1401156868374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA01071981OtherBIRTH DATE