Provider Demographics
NPI:1639347149
Name:WITTHUHN, CYNTHIA MANSELL (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:MANSELL
Last Name:WITTHUHN
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 1:2121 SEBASTIAN CT
Mailing Address - Street 2:
Mailing Address - City:ALVA
Mailing Address - State:FL
Mailing Address - Zip Code:33920-3824
Mailing Address - Country:US
Mailing Address - Phone:239-222-3533
Mailing Address - Fax:
Practice Address - Street 1:2121 SEBASTIAN CT
Practice Address - Street 2:
Practice Address - City:ALVA
Practice Address - State:FL
Practice Address - Zip Code:33920-3824
Practice Address - Country:US
Practice Address - Phone:239-222-3533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-19
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1182032163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY7404YMedicare PIN
FLS62665Medicare UPIN