Provider Demographics
NPI:1205245404
Name:NORRID, CINNAMON D (FNP)
Entity type:Individual
Prefix:MS
First Name:CINNAMON
Middle Name:D
Last Name:NORRID
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:CINNAMON
Other - Middle Name:D
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:303 W SUNSHINE ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-2656
Mailing Address - Country:US
Mailing Address - Phone:417-986-0452
Mailing Address - Fax:
Practice Address - Street 1:303 W SUNSHINE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-2656
Practice Address - Country:US
Practice Address - Phone:417-986-0452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-13
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014026218363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420016201Medicaid