Provider Demographics
NPI:1437412004
Name:CROTHERS, CINDY R (FNP-C)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:R
Last Name:CROTHERS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MISS
Other - First Name:CINDY
Other - Middle Name:R
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2675 WINKLER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9342
Mailing Address - Country:US
Mailing Address - Phone:877-856-3774
Mailing Address - Fax:239-599-2612
Practice Address - Street 1:1720 E VENICE AVE FL 2
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-3190
Practice Address - Country:US
Practice Address - Phone:941-483-9730
Practice Address - Fax:941-483-9745
Is Sole Proprietor?:No
Enumeration Date:2012-06-19
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN1101683363LF0000X
GARN133687363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003125381BMedicaid
GA202I505058Medicare PIN