Provider Demographics
NPI:1871673525
Name:OZAWA, CYNTHIA SALUPEN (APN)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:SALUPEN
Last Name:OZAWA
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:458 WENDOVER HILLS AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-6028
Mailing Address - Country:US
Mailing Address - Phone:702-435-9694
Mailing Address - Fax:
Practice Address - Street 1:8985 S PECOS RD
Practice Address - Street 2:SUITE 4A
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7162
Practice Address - Country:US
Practice Address - Phone:702-433-1332
Practice Address - Fax:702-547-4931
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2011-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV848363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily