Provider Demographics
NPI:1659606069
Name:COFER, CYNTHIA ANNE (RN)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ANNE
Last Name:COFER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:CYNTHIA
Other - Middle Name:ANNE
Other - Last Name:ROSSCUP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3180 CENTER ST NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301
Mailing Address - Country:US
Mailing Address - Phone:503-576-4678
Mailing Address - Fax:503-566-2948
Practice Address - Street 1:3180 CENTER ST NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-4532
Practice Address - Country:US
Practice Address - Phone:503-588-5011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-03
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR087000225RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse