Provider Demographics
NPI:1407842925
Name:CALDWELL, CINDY MAENO (FNP-C)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:MAENO
Last Name:CALDWELL
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 1:701 N SLAPPEY BLVD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-1413
Mailing Address - Country:US
Mailing Address - Phone:229-430-6061
Mailing Address - Fax:229-430-6002
Practice Address - Street 1:701 N SLAPPEY BLVD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-1413
Practice Address - Country:US
Practice Address - Phone:229-430-6061
Practice Address - Fax:229-430-6002
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN115517363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA289441250DMedicaid
GAQ50790Medicare UPIN
GA202I508612Medicare PIN