Provider Demographics
NPI:1457831570
Name:ACOB, CYNTHIA P (RN)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:P
Last Name:ACOB
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19686 ROSEBUD PL NE
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-8547
Mailing Address - Country:US
Mailing Address - Phone:757-358-5943
Mailing Address - Fax:
Practice Address - Street 1:19686 ROSEBUD PL NE
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-8547
Practice Address - Country:US
Practice Address - Phone:757-358-5943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00145371163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care