Provider Demographics
NPI:1275514119
Name:CORREIA, CYNTHIA ANN (APRN)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ANN
Last Name:CORREIA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:A
Other - Last Name:SOKUL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:138 WEBSTER ST
Mailing Address - Street 2:SENIOR HEALTH PRIMARY CARE
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-2512
Mailing Address - Country:US
Mailing Address - Phone:603-663-7030
Mailing Address - Fax:603-663-7039
Practice Address - Street 1:138 WEBSTER ST
Practice Address - Street 2:SENIOR HEALTH PRIMARY CARE
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-2512
Practice Address - Country:US
Practice Address - Phone:603-663-7030
Practice Address - Fax:603-663-7039
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH022474-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHAA11320OtherHPHC PIN
NHRE6661OtherMEDICARE GROUP
NH500019872OtherRR MEDICARE PIN
NH30341705Medicaid
NHRE5600OtherMEDICARE GROUP
NHAA11320OtherHPHC PIN
NHNP1533Medicare PIN