Provider Demographics
NPI:1821553694
Name:KAMM, CYNTHIA ELIZABETH (APRN FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ELIZABETH
Last Name:KAMM
Suffix:
Gender:F
Credentials:APRN FNP-C
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Other - First Name:
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Mailing Address - Street 1:1202 LOUISIANA AVE
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-3910
Mailing Address - Country:US
Mailing Address - Phone:318-212-8951
Mailing Address - Fax:318-212-6752
Practice Address - Street 1:1811 E BERT KOUN LOOP STE 210
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5740
Practice Address - Country:US
Practice Address - Phone:318-212-3858
Practice Address - Fax:318-212-3958
Is Sole Proprietor?:No
Enumeration Date:2019-02-06
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA203676363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily