Provider Demographics
NPI:1417114943
Name:PHAIR, LUCINDA S (RN MA MSCN)
Entity Type:Individual
Prefix:
First Name:LUCINDA
Middle Name:S
Last Name:PHAIR
Suffix:
Gender:F
Credentials:RN MA MSCN
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:S
Other - Last Name:PHAIR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN MA MSCN
Mailing Address - Street 1:4225 GOLDEN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-4215
Mailing Address - Country:US
Mailing Address - Phone:763-588-0661
Mailing Address - Fax:763-529-9018
Practice Address - Street 1:4225 GOLDEN VALLEY RD
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55422-4215
Practice Address - Country:US
Practice Address - Phone:763-588-0661
Practice Address - Fax:763-529-9018
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR0994941163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse