Provider Demographics
NPI:1700022589
Name:MRLA, CYNTHIA M (APN)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:M
Last Name:MRLA
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:758 GILPIN CIR
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:CO
Mailing Address - Zip Code:80516-2578
Mailing Address - Country:US
Mailing Address - Phone:303-859-5907
Mailing Address - Fax:
Practice Address - Street 1:758 GILPIN CIR
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:CO
Practice Address - Zip Code:80516-2578
Practice Address - Country:US
Practice Address - Phone:303-859-5907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-27
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0994391363L00000X
CO169908163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse