Provider Demographics
NPI:1255405619
Name:CHURGIN, CYNTHIA (FNP, CNM)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:
Last Name:CHURGIN
Suffix:
Gender:F
Credentials:FNP, CNM
Other - Prefix:MS
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:WOLKOVE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP, CNM
Mailing Address - Street 1:1760 E PECOS RD STE 235
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-3207
Mailing Address - Country:US
Mailing Address - Phone:480-813-0944
Mailing Address - Fax:480-813-0038
Practice Address - Street 1:1760 E PECOS RD STE 235
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-3207
Practice Address - Country:US
Practice Address - Phone:480-813-0944
Practice Address - Fax:480-813-0038
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN045531367A00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZR49661Medicare UPIN