Provider Demographics
NPI:1699032045
Name:CORMIER, CESILY CALDWELL (MSN, ACNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:CESILY
Middle Name:CALDWELL
Last Name:CORMIER
Suffix:
Gender:F
Credentials:MSN, ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5414 WOODRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77632-6608
Mailing Address - Country:US
Mailing Address - Phone:409-454-6119
Mailing Address - Fax:
Practice Address - Street 1:740 HOSPITAL DR
Practice Address - Street 2:SUITE 210
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-4664
Practice Address - Country:US
Practice Address - Phone:409-839-4757
Practice Address - Fax:409-839-4294
Is Sole Proprietor?:No
Enumeration Date:2012-04-23
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX703635363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care