Provider Demographics
NPI:1598170490
Name:MANUEL, CYNTHIA CECELIA (RN)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:CECELIA
Last Name:MANUEL
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:PO BOX 810
Mailing Address - Street 2:
Mailing Address - City:SELLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85634-0810
Mailing Address - Country:US
Mailing Address - Phone:520-383-6200
Mailing Address - Fax:520-383-8810
Practice Address - Street 1:ARIZONA STATE HIGHWAY 86
Practice Address - Street 2:MILE POST 112
Practice Address - City:SELLS
Practice Address - State:AZ
Practice Address - Zip Code:85634-0810
Practice Address - Country:US
Practice Address - Phone:520-383-6200
Practice Address - Fax:520-383-8810
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN134429163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse