Provider Demographics
NPI:1376857110
Name:ROSS, CYNTHIA KEEL (DNSC, ARNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:KEEL
Last Name:ROSS
Suffix:
Gender:F
Credentials:DNSC, ARNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 SUMMERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-9799
Mailing Address - Country:US
Mailing Address - Phone:731-431-5234
Mailing Address - Fax:731-664-5234
Practice Address - Street 1:237 SUMMERFIELD DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-9799
Practice Address - Country:US
Practice Address - Phone:731-431-5234
Practice Address - Fax:731-664-5234
Is Sole Proprietor?:No
Enumeration Date:2010-08-04
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN000006160363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily