Provider Demographics
NPI:1235178880
Name:DEAN, CYNTHIA M (CNM)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:M
Last Name:DEAN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1175 58TH AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-4808
Mailing Address - Country:US
Mailing Address - Phone:970-495-0444
Mailing Address - Fax:970-224-9624
Practice Address - Street 1:1175 58TH AVE
Practice Address - Street 2:STE 200
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-4808
Practice Address - Country:US
Practice Address - Phone:970-495-0444
Practice Address - Fax:970-224-9624
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCNM-173367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07897721Medicaid
R18726Medicare UPIN
CO07897721Medicaid
COCOA104788Medicare PIN