Provider Demographics
NPI:1629701826
Name:OREBAUGH, CYDNI
Entity Type:Individual
Prefix:
First Name:CYDNI
Middle Name:
Last Name:OREBAUGH
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 1:203 RUSHMORE WAY
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-4333
Mailing Address - Country:US
Mailing Address - Phone:770-364-6302
Mailing Address - Fax:
Practice Address - Street 1:2141 KINGSTON CT SE STE 103
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-8928
Practice Address - Country:US
Practice Address - Phone:770-644-0555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN221259163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant