Provider Demographics
NPI:1477205789
Name:WHEELER, CYNTHIA DAWN (FNP-C)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:DAWN
Last Name:WHEELER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3160 NE 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-2732
Mailing Address - Country:US
Mailing Address - Phone:903-736-3267
Mailing Address - Fax:
Practice Address - Street 1:4701 S FLAMINGO RD
Practice Address - Street 2:
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33330-2312
Practice Address - Country:US
Practice Address - Phone:954-434-3160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11016510363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily