Provider Demographics
NPI:1942463831
Name:RUNKLE, CINDY L (FNP)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:L
Last Name:RUNKLE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:L
Other - Last Name:COLLYOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1115 BOULDERS PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23225-4067
Mailing Address - Country:US
Mailing Address - Phone:804-915-4607
Mailing Address - Fax:804-509-9029
Practice Address - Street 1:12200 WARWICK BLVD STE 310
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23601
Practice Address - Country:US
Practice Address - Phone:757-534-9988
Practice Address - Fax:757-534-5688
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024176449363LF0000X
PASP028773363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily