Provider Demographics
NPI:1598426330
Name:HARPER, CYNTHIA LENETTE (NP)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:LENETTE
Last Name:HARPER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3191 OAKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86404-3311
Mailing Address - Country:US
Mailing Address - Phone:912-424-2043
Mailing Address - Fax:
Practice Address - Street 1:8700 AZ-95
Practice Address - Street 2:
Practice Address - City:MOHAVE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86440
Practice Address - Country:US
Practice Address - Phone:928-768-7113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-04
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ268121363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner