Provider Demographics
NPI:1497408728
Name:STINNETT, CYNTHIA LOUISE
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:LOUISE
Last Name:STINNETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4369 BISHOP CIR
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709-3436
Mailing Address - Country:US
Mailing Address - Phone:907-312-8934
Mailing Address - Fax:
Practice Address - Street 1:3406 ALDER AVE
Practice Address - Street 2:
Practice Address - City:FORT WAINWRIGHT
Practice Address - State:AK
Practice Address - Zip Code:99703-4613
Practice Address - Country:US
Practice Address - Phone:907-353-1433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-27
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program