Provider Demographics
NPI:1598357865
Name:MAUPIN, CIERRA NICOLE
Entity Type:Individual
Prefix:
First Name:CIERRA
Middle Name:NICOLE
Last Name:MAUPIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 W KING ST APT 4
Mailing Address - Street 2:
Mailing Address - City:WARRENSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:64093-2974
Mailing Address - Country:US
Mailing Address - Phone:660-441-9129
Mailing Address - Fax:
Practice Address - Street 1:509 W KING ST APT 4
Practice Address - Street 2:
Practice Address - City:WARRENSBURG
Practice Address - State:MO
Practice Address - Zip Code:64093-2974
Practice Address - Country:US
Practice Address - Phone:660-441-9129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Single Specialty