Provider Demographics
NPI:1689699795
Name:SMITH, CYNTHIA A (RN-C, FNP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:A
Last Name:SMITH
Suffix:
Gender:F
Credentials:RN-C, FNP
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:A
Other - Last Name:GREENWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN-C, FNP
Mailing Address - Street 1:601A MALLARD LN
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:TX
Mailing Address - Zip Code:76574-1214
Mailing Address - Country:US
Mailing Address - Phone:512-352-3200
Mailing Address - Fax:512-352-3201
Practice Address - Street 1:601A MALLARD LN
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:TX
Practice Address - Zip Code:76574-1214
Practice Address - Country:US
Practice Address - Phone:512-352-3200
Practice Address - Fax:512-352-4734
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX231944363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily