Provider Demographics
NPI:1205116795
Name:DAVIS, CYNTHIA (CINDY) R (CRNP)
Entity type:Individual
Prefix:
First Name:CYNTHIA (CINDY)
Middle Name:R
Last Name:DAVIS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4231 N WOODS TRL
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:MD
Mailing Address - Zip Code:21074-3128
Mailing Address - Country:US
Mailing Address - Phone:410-374-9391
Mailing Address - Fax:410-871-7967
Practice Address - Street 1:4231 N WOODS TRL
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:MD
Practice Address - Zip Code:21074-3128
Practice Address - Country:US
Practice Address - Phone:410-374-9391
Practice Address - Fax:410-871-7967
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-28
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR068683207R00000X, 363L00000X, 363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care