Provider Demographics
NPI:1366840548
Name:MCMAKEN, CYNTHIA (FNP-C)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:MCMAKEN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 EMMANUEL WAY STE B
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45502-7218
Mailing Address - Country:US
Mailing Address - Phone:937-504-0120
Mailing Address - Fax:937-521-1092
Practice Address - Street 1:360 WILSON DR
Practice Address - Street 2:
Practice Address - City:XENIA
Practice Address - State:OH
Practice Address - Zip Code:45385-1810
Practice Address - Country:US
Practice Address - Phone:937-708-3400
Practice Address - Fax:937-708-3430
Is Sole Proprietor?:No
Enumeration Date:2014-12-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.16893-NP363LF0000X
OHAPRN.CNP.16893363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily