Provider Demographics
NPI:1184014482
Name:LEINO-HANDFORD, CYNTHIA (RN)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:LEINO-HANDFORD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25200 TELEGRAPH RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-2543
Mailing Address - Country:US
Mailing Address - Phone:248-351-7979
Mailing Address - Fax:248-351-2101
Practice Address - Street 1:25200 TELEGRAPH RD
Practice Address - Street 2:SUITE 110
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-2543
Practice Address - Country:US
Practice Address - Phone:248-351-7979
Practice Address - Fax:248-351-2101
Is Sole Proprietor?:No
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704136282163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4704136282OtherREGISTERED NURSE