Provider Demographics
NPI:1184610834
Name:MAUGLE, CYNTHIA ANN (CRNA)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ANN
Last Name:MAUGLE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 S CEDAR CREST BLVD
Mailing Address - Street 2:SUITE #301
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6258
Mailing Address - Country:US
Mailing Address - Phone:610-402-9099
Mailing Address - Fax:610-402-9029
Practice Address - Street 1:1200 S CEDAR CREST BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6202
Practice Address - Country:US
Practice Address - Phone:610-402-9099
Practice Address - Fax:610-402-9029
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN506328L163W00000X
PA071122367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1575794OtherFIRST PRIORITY
PA1027800750001Medicaid
PA1547804OtherGATEWAY
PA2255623000OtherINDEP. BLUE CROSS
PA50026735OtherCAPITAL ADVANTAGE
PA84346OtherGEISINGER
PA9104438OtherAETNA
PA11744010OtherCAQH
PA1575794OtherHIGHMARK
PA2000102OtherKHP CENTRAL
PA1575794OtherFIRST PRIORITY
PA1027800750001Medicaid
PA2255623000OtherINDEP. BLUE CROSS
PA075775QCYMedicare PIN