Provider Demographics
NPI:1407902968
Name:MULDER, CINDY KAY (CNP)
Entity Type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:KAY
Last Name:MULDER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3048 AMANDA CT
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57103
Mailing Address - Country:US
Mailing Address - Phone:605-371-8785
Mailing Address - Fax:605-338-1820
Practice Address - Street 1:909 SOUTH MILLER
Practice Address - Street 2:MITCHELL FAMILY PLANNING
Practice Address - City:MITCHELL
Practice Address - State:SD
Practice Address - Zip Code:57301
Practice Address - Country:US
Practice Address - Phone:605-995-8040
Practice Address - Fax:605-995-8058
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR012514CNP0342363LF0000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Not Answered363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5100230Medicaid
SD5100230Medicaid
SD6869Medicare ID - Type Unspecified