Provider Demographics
NPI:1942276845
Name:HOLCOMB, CINDY OLIVER (CFNP)
Entity Type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:OLIVER
Last Name:HOLCOMB
Suffix:
Gender:F
Credentials:CFNP
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 448
Mailing Address - Street 2:2686 HWY 145 SOUTH STE B
Mailing Address - City:SALTILLO
Mailing Address - State:MS
Mailing Address - Zip Code:38866-0448
Mailing Address - Country:US
Mailing Address - Phone:662-869-8693
Mailing Address - Fax:662-869-0110
Practice Address - Street 1:2686 HIGHWAY 145
Practice Address - Street 2:
Practice Address - City:SALTILLO
Practice Address - State:MS
Practice Address - Zip Code:38866-6941
Practice Address - Country:US
Practice Address - Phone:662-869-8693
Practice Address - Fax:662-869-0110
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR850782363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00125593Medicaid
MS06489045Medicaid
MSC02686Medicare PIN
MSP53566Medicare UPIN
MS00125593Medicaid