Provider Demographics
NPI:1598858268
Name:FULLBRIGHT, CYNTHIA MESNEAK (ARNP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:MESNEAK
Last Name:FULLBRIGHT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6601 PRESTON RD
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-2502
Mailing Address - Country:US
Mailing Address - Phone:469-800-6300
Mailing Address - Fax:
Practice Address - Street 1:6601 PRESTON RD
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-2502
Practice Address - Country:US
Practice Address - Phone:469-800-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA111682363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAQ44659Medicare UPIN