Provider Demographics
NPI:1790741619
Name:NEVARA, CINDY LEE (RN,APN-C)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:LEE
Last Name:NEVARA
Suffix:
Gender:F
Credentials:RN,APN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 593
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-0593
Mailing Address - Country:US
Mailing Address - Phone:609-463-2757
Mailing Address - Fax:
Practice Address - Street 1:223 N MAIN ST STE 103
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-2182
Practice Address - Country:US
Practice Address - Phone:609-465-7557
Practice Address - Fax:609-465-9383
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0038769163W00000X
PARN310556L163W00000X
NJ26NJ00005100363LA2200X
PAVP003896G363LW0102X
DELH-0000192363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8901309Medicaid
NJP75028Medicare UPIN
NJ065172AH9Medicare ID - Type Unspecified