Provider Demographics
NPI:1265250898
Name:SMIDDY, CYNTHIA MARIE (CNM-APRN)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:MARIE
Last Name:SMIDDY
Suffix:
Gender:F
Credentials:CNM-APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 WORTHLEY RD
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-5120
Mailing Address - Country:US
Mailing Address - Phone:603-479-4732
Mailing Address - Fax:
Practice Address - Street 1:17 WORTHLEY RD
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-5120
Practice Address - Country:US
Practice Address - Phone:603-479-4732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH058420-23367A00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner