Provider Demographics
NPI:1790167310
Name:SHOWMAN, CYNTHIA (RN)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:SHOWMAN
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 1:6200 ONTARIO CENTER RD.
Mailing Address - Street 2:
Mailing Address - City:ONTARIO CENTER
Mailing Address - State:NY
Mailing Address - Zip Code:14520-0155
Mailing Address - Country:US
Mailing Address - Phone:315-524-1172
Mailing Address - Fax:
Practice Address - Street 1:6179 FURNACE RD
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:NY
Practice Address - Zip Code:14519-8903
Practice Address - Country:US
Practice Address - Phone:315-524-1172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-19
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY307708163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY307708OtherREGISTERED NURSE, SCHOOL