Provider Demographics
NPI:1518140573
Name:LIGHTNER, CYNTHIA RAYSON (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:RAYSON
Last Name:LIGHTNER
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
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Mailing Address - Street 1:2200 BERGQUIST DR STE 1
Mailing Address - Street 2:ATTN: CREDENTIALS (SGHC)
Mailing Address - City:LACKLAND A F B
Mailing Address - State:TX
Mailing Address - Zip Code:78236-9908
Mailing Address - Country:US
Mailing Address - Phone:210-292-6707
Mailing Address - Fax:210-292-7964
Practice Address - Street 1:2200 BERGQUIST DR STE 1
Practice Address - Street 2:ATTN: CREDENTIALS (SGHC)
Practice Address - City:LACKLAND A F B
Practice Address - State:TX
Practice Address - Zip Code:78236-9908
Practice Address - Country:US
Practice Address - Phone:210-292-6707
Practice Address - Fax:210-292-7964
Is Sole Proprietor?:No
Enumeration Date:2007-12-13
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX693404363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health