Provider Demographics
NPI:1023011814
Name:DEAN, CYNTHIA (FNP)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:
Last Name:DEAN
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 1:276 FIELDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:JONESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24263-1215
Mailing Address - Country:US
Mailing Address - Phone:276-546-5310
Mailing Address - Fax:276-546-5469
Practice Address - Street 1:241 MONARCH ROAD
Practice Address - Street 2:
Practice Address - City:ST. CHARLES
Practice Address - State:VA
Practice Address - Zip Code:24282-0269
Practice Address - Country:US
Practice Address - Phone:276-383-4428
Practice Address - Fax:276-383-4927
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN 7366363LF0000X
VA0024164685363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3971844Medicaid
VA1871547794Medicaid
VA7789858Medicaid
VA500000798Medicare PIN
VA7789858Medicaid
VAV V3864AMedicare PIN
TN500019924Medicare PIN
TN3971844Medicare ID - Type Unspecified
VA1871547794Medicaid
TN3971844Medicaid
TN0281780001Medicare PIN
TN0281780003Medicare PIN
VA500000798Medicare ID - Type Unspecified
TNCA5023Medicare PIN
VAC05950Medicare PIN
TN103I086169Medicare UPIN
TN103I509268Medicare PIN
VAC06181Medicare PIN
VAP00916398Medicare PIN
TN103I503184Medicare PIN
TN103I502939Medicare PIN
VAVAA101312Medicare PIN
VAV V3486BMedicare PIN