Provider Demographics
NPI:1851549513
Name:MALLEE, CYNTHIA LEE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:LEE
Last Name:MALLEE
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:363 MISTY VALE DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-2125
Mailing Address - Country:US
Mailing Address - Phone:320-376-8629
Mailing Address - Fax:
Practice Address - Street 1:1201 COLLEGE PARK DRIVE
Practice Address - Street 2:CMS ROUTE 113
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904
Practice Address - Country:US
Practice Address - Phone:302-856-5280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-05
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0000471363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily