Provider Demographics
NPI:1518095140
Name:GLISTA, CYNTHIA E (RN)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:E
Last Name:GLISTA
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 1:150 BUCKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-2118
Mailing Address - Country:US
Mailing Address - Phone:508-771-4409
Mailing Address - Fax:
Practice Address - Street 1:105 PARK ST
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-5205
Practice Address - Country:US
Practice Address - Phone:508-771-9599
Practice Address - Fax:508-771-1986
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA123208163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health