Provider Demographics
NPI:1801860341
Name:MCCUMBERS, CYNTHIA K (NP)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:K
Last Name:MCCUMBERS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:YODER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 W 42ND ST
Mailing Address - Street 2:STE 2200
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-0617
Mailing Address - Country:US
Mailing Address - Phone:308-630-2626
Mailing Address - Fax:308-630-2636
Practice Address - Street 1:2 W 42ND ST
Practice Address - Street 2:STE 2200
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-0617
Practice Address - Country:US
Practice Address - Phone:308-630-2626
Practice Address - Fax:308-630-2636
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110669363LA2100X
NE57081163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025925600Medicaid
WY121910300Medicaid
CO51679841Medicaid
Q24354Medicare UPIN
WY121910300Medicaid
NE279647Medicare ID - Type UnspecifiedPROVIDER ID
CO51679841Medicaid