Provider Demographics
NPI:1346347440
Name:CULLEN, CYNTHIA (CNM)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:CULLEN
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 1:540 WOODBOURNE RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1856
Mailing Address - Country:US
Mailing Address - Phone:215-750-6611
Mailing Address - Fax:215-750-6960
Practice Address - Street 1:540 WOODBOURNE RD
Practice Address - Street 2:SUITE 1
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1856
Practice Address - Country:US
Practice Address - Phone:215-750-6611
Practice Address - Fax:215-750-6960
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMW0083541363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1632052OtherHIGHMARK PA BS
PA1632052OtherPERSONAL CHOICE
PA2307711000OtherKEYSTONE HEALTH PLAN EAST
PA1632052OtherAMERIHEALTH PERS.CHOICE
PA2307711000OtherAMERIHEALTH HMO