Provider Demographics
NPI:1467786533
Name:MOTTERN, CINDY LEIGH (RN)
Entity Type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:LEIGH
Last Name:MOTTERN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:CYNTHIA
Other - Middle Name:LEIGH
Other - Last Name:CANTLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:154 BLOUNTVILLE BYP
Mailing Address - Street 2:
Mailing Address - City:BLOUNTVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37617-4575
Mailing Address - Country:US
Mailing Address - Phone:423-963-6791
Mailing Address - Fax:
Practice Address - Street 1:154 BLOUNTVILLE BYP
Practice Address - Street 2:
Practice Address - City:BLOUNTVILLE
Practice Address - State:TN
Practice Address - Zip Code:37617-4575
Practice Address - Country:US
Practice Address - Phone:423-963-6791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000107362163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health