Provider Demographics
NPI:1558447680
Name:TOBIN, CINDY A (NP)
Entity Type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:A
Last Name:TOBIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:CINDY
Other - Middle Name:A
Other - Last Name:NEEDHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:3621 S STATE ST
Mailing Address - Street 2:700 KMS PLACE
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108
Mailing Address - Country:US
Mailing Address - Phone:734-936-2047
Mailing Address - Fax:
Practice Address - Street 1:1500 E MEDICAL CENTER DR
Practice Address - Street 2:CARDIOVASCULAR CENTER FLOOR 3
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-5856
Practice Address - Country:US
Practice Address - Phone:888-287-1082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704188658363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4812200Medicaid
MIQ67860Medicare UPIN
MI0M97190120Medicare ID - Type Unspecified