Provider Demographics
NPI:1881644862
Name:EARLY, CYNTHIA A (FNP)
Entity Type:Individual
Prefix:PROF
First Name:CYNTHIA
Middle Name:A
Last Name:EARLY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2156 N HIGHLAND AVE
Mailing Address - Street 2:SUITE B108
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-4915
Mailing Address - Country:US
Mailing Address - Phone:731-300-1058
Mailing Address - Fax:877-571-0129
Practice Address - Street 1:1124 WHITEHALL ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301-8742
Practice Address - Country:US
Practice Address - Phone:731-300-1058
Practice Address - Fax:877-571-0129
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000005917363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily