Provider Demographics
NPI:1689042236
Name:THORNTON, CYNTHIA (RN)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:THORNTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7237 W MISSOURI AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85303-5221
Mailing Address - Country:US
Mailing Address - Phone:623-237-4009
Mailing Address - Fax:623-237-4915
Practice Address - Street 1:7237 W MISSOURI AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85303-5221
Practice Address - Country:US
Practice Address - Phone:623-237-4009
Practice Address - Fax:623-237-4915
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-11
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN150276163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse