Provider Demographics
NPI:1275809121
Name:FORTE, CYNTHIA A (LPN)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:A
Last Name:FORTE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:CYNTHIA
Other - Middle Name:A
Other - Last Name:BOYD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:33 OLD SCHOOLHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360
Mailing Address - Country:US
Mailing Address - Phone:508-904-0610
Mailing Address - Fax:
Practice Address - Street 1:33 OLD SCHOOL HOUSE RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-1712
Practice Address - Country:US
Practice Address - Phone:508-904-0610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-26
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN86882164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse