Provider Demographics
NPI:1518511559
Name:CROSS, CYNTHIA DEW (NP-C)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:DEW
Last Name:CROSS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:GRANITE FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56241-1442
Mailing Address - Country:US
Mailing Address - Phone:320-313-3607
Mailing Address - Fax:320-564-1297
Practice Address - Street 1:345 10TH AVE
Practice Address - Street 2:
Practice Address - City:GRANITE FALLS
Practice Address - State:MN
Practice Address - Zip Code:56241-1442
Practice Address - Country:US
Practice Address - Phone:320-313-3607
Practice Address - Fax:320-564-1297
Is Sole Proprietor?:No
Enumeration Date:2019-07-29
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6771363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily