Provider Demographics
NPI:1922731850
Name:MCNICOL, CINDY PU (CNP)
Entity Type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:PU
Last Name:MCNICOL
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 370476
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89137-0476
Mailing Address - Country:US
Mailing Address - Phone:702-228-9888
Mailing Address - Fax:
Practice Address - Street 1:7720 W SAHARA AVE STE 103
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2754
Practice Address - Country:US
Practice Address - Phone:702-228-9888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-07
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0031692363LF0000X
NV864285363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily