Provider Demographics
NPI:1629625884
Name:GAY, CYNTHIA MARIE (CNP)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:MARIE
Last Name:GAY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2602 W RICHEY AVE APT 1202
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:NM
Mailing Address - Zip Code:88210-9660
Mailing Address - Country:US
Mailing Address - Phone:251-751-0345
Mailing Address - Fax:
Practice Address - Street 1:602 S 4TH ST
Practice Address - Street 2:
Practice Address - City:LOVING
Practice Address - State:NM
Practice Address - Zip Code:88256
Practice Address - Country:US
Practice Address - Phone:575-745-3573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-22
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM57167363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily