Provider Demographics
NPI:1184120677
Name:CROSS, CYNTHIA L (APN)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:L
Last Name:CROSS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2341 MCCALLIE AVE STE 403
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-3227
Mailing Address - Country:US
Mailing Address - Phone:423-698-2435
Mailing Address - Fax:423-697-6173
Practice Address - Street 1:2341 MCCALLIE AVE STE 403
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-3227
Practice Address - Country:US
Practice Address - Phone:423-698-2435
Practice Address - Fax:423-697-6173
Is Sole Proprietor?:No
Enumeration Date:2018-04-03
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN24049363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN24049OtherAPN LICENSE