Provider Demographics
NPI:1851696991
Name:POORE, CYNTHIA FAYE (MSN, CRNP)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:FAYE
Last Name:POORE
Suffix:
Gender:F
Credentials:MSN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3686 GRANDVIEW PKWY STE 320
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-3404
Mailing Address - Country:US
Mailing Address - Phone:205-971-5499
Mailing Address - Fax:
Practice Address - Street 1:3686 GRANDVIEW PKWY STE 320
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243-3404
Practice Address - Country:US
Practice Address - Phone:205-971-5499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-21
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-110965363LF0000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily