Provider Demographics
NPI:1922784941
Name:BOOTH, CINDY NICOLE (MSN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:NICOLE
Last Name:BOOTH
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:NICOLE
Other - Last Name:MARTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 776084
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6084
Mailing Address - Country:US
Mailing Address - Phone:314-364-4200
Mailing Address - Fax:314-364-6321
Practice Address - Street 1:1420 N H ST
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72901-2871
Practice Address - Country:US
Practice Address - Phone:479-784-8131
Practice Address - Fax:479-709-6025
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR221971363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily