Provider Demographics
NPI:1649584814
Name:TUFARELLA, CYNTHIA L (NP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:L
Last Name:TUFARELLA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8333 ALEXANDRIA PIKE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:KY
Mailing Address - Zip Code:41001-1187
Mailing Address - Country:US
Mailing Address - Phone:859-694-4000
Mailing Address - Fax:859-694-4200
Practice Address - Street 1:8333 ALEXANDRIA PIKE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:KY
Practice Address - Zip Code:41001-1187
Practice Address - Country:US
Practice Address - Phone:859-694-4000
Practice Address - Fax:859-694-4200
Is Sole Proprietor?:No
Enumeration Date:2010-07-30
Last Update Date:2023-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1133501163W00000X
OHAPRN.CNP.11863163W00000X, 363LP0808X
KY3007662363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3106801Medicaid