Provider Demographics
NPI:1760792683
Name:BURKHOLDER, CYNTHIA D (ARNP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:D
Last Name:BURKHOLDER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1236 E RUSHOLME ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52803-2434
Mailing Address - Country:US
Mailing Address - Phone:563-324-2992
Mailing Address - Fax:563-888-0499
Practice Address - Street 1:1236 E RUSHOLME ST
Practice Address - Street 2:SUITE 300
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52803-2434
Practice Address - Country:US
Practice Address - Phone:563-324-2992
Practice Address - Fax:563-888-0499
Is Sole Proprietor?:No
Enumeration Date:2010-10-13
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAL-104488363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care