Provider Demographics
NPI:1023056215
Name:MESSER, CYNTHIA F (CNM)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:F
Last Name:MESSER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 19TH AVE
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39301-4116
Mailing Address - Country:US
Mailing Address - Phone:601-703-3018
Mailing Address - Fax:601-703-9283
Practice Address - Street 1:905C S FRONTAGE RD
Practice Address - Street 2:SUITE C
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39301-6113
Practice Address - Country:US
Practice Address - Phone:601-703-3018
Practice Address - Fax:601-703-9283
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-034962367A00000X
MSR859651367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS04779888Medicaid
AL51518824OtherBLUE CROSS
FL340424200Medicaid
AL569100090Medicaid
LA1169153Medicaid
AL51518826OtherBLUE CROSS
AL51518824OtherBLUE CROSS
AL051518826Medicare ID - Type Unspecified
AL569100090Medicaid
MS04779888Medicaid