Provider Demographics
NPI:1639327307
Name:KIEFER, CYNTHIE MICHELLE (PA)
Entity Type:Individual
Prefix:
First Name:CYNTHIE
Middle Name:MICHELLE
Last Name:KIEFER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6580 S MCCARRAN BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-6140
Mailing Address - Country:US
Mailing Address - Phone:775-440-1500
Mailing Address - Fax:775-440-1515
Practice Address - Street 1:6580 S MCCARRAN BLVD STE C
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6140
Practice Address - Country:US
Practice Address - Phone:775-440-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-05
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA1582363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical