Provider Demographics
NPI:1346337920
Name:HARRINGTON, CYNTHIA (FNP)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:
Last Name:HARRINGTON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 VANCE ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39339-9052
Mailing Address - Country:US
Mailing Address - Phone:662-803-0415
Mailing Address - Fax:
Practice Address - Street 1:14724 HIGHWAY 15 N
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:MS
Practice Address - Zip Code:39339-6318
Practice Address - Country:US
Practice Address - Phone:662-773-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR860457363L00000X
MS860457363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS5000023000OtherMEDICARE
MS05438767Medicaid
MS05438767Medicaid