Provider Demographics
NPI:1235389776
Name:TAYLOR, CYNTHIA M (CSFA)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:M
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:CSFA
Other - Prefix:MISS
Other - First Name:CYNTHIA
Other - Middle Name:M
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSFA
Mailing Address - Street 1:8718 E 116TH ST N
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-6527
Mailing Address - Country:US
Mailing Address - Phone:918-557-2576
Mailing Address - Fax:
Practice Address - Street 1:8718 E 116TH ST N
Practice Address - Street 2:
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-6527
Practice Address - Country:US
Practice Address - Phone:918-557-2576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-21
Last Update Date:2017-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK067795246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant