Provider Demographics
NPI:1457310864
Name:DOUTHITT, CINDY E (RN MSN FNP)
Entity Type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:E
Last Name:DOUTHITT
Suffix:
Gender:F
Credentials:RN MSN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:VINCENNES
Mailing Address - State:IN
Mailing Address - Zip Code:47591-1022
Mailing Address - Country:US
Mailing Address - Phone:812-885-3703
Mailing Address - Fax:812-885-3707
Practice Address - Street 1:102 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:IN
Practice Address - Zip Code:47471-1603
Practice Address - Country:US
Practice Address - Phone:812-847-4481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001024A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1050074OtherANTHEM
IN200322320Medicaid
IN941140049OtherMEDICARE
P25079Medicare UPIN
IN200322320AMedicaid
INCG3197OtherMEDICARE RAILROAD GROUP