Provider Demographics
NPI:1225039944
Name:STOKES, CYNTHIA (RN, MSN, CNM)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:STOKES
Suffix:
Gender:F
Credentials:RN, MSN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 S CHADBOURNE ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76903-8510
Mailing Address - Country:US
Mailing Address - Phone:325-658-5339
Mailing Address - Fax:325-659-8534
Practice Address - Street 1:1610 S CHADBOURNE ST
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76903-8510
Practice Address - Country:US
Practice Address - Phone:325-658-5339
Practice Address - Fax:325-659-8534
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-03
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX250348367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX111604802Medicaid
00324RMedicare ID - Type Unspecified
TX111604802Medicaid