Provider Demographics
NPI:1598436883
Name:AZURE, CYNTHIA RUTH
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:RUTH
Last Name:AZURE
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 1:111 1ST ST SE APT 11
Mailing Address - Street 2:
Mailing Address - City:DUNSEITH
Mailing Address - State:ND
Mailing Address - Zip Code:58329-2904
Mailing Address - Country:US
Mailing Address - Phone:701-472-1565
Mailing Address - Fax:
Practice Address - Street 1:111 1ST ST SE APT 11
Practice Address - Street 2:
Practice Address - City:DUNSEITH
Practice Address - State:ND
Practice Address - Zip Code:58329-2904
Practice Address - Country:US
Practice Address - Phone:701-472-1565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-25
Last Update Date:2021-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker