Provider Demographics
NPI:1295423309
Name:MARTIN, CYILEE (RN)
Entity type:Individual
Prefix:
First Name:CYILEE
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CYILEE
Other - Middle Name:
Other - Last Name:MCCABE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1720 N 16TH ST STE K
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51501-0109
Mailing Address - Country:US
Mailing Address - Phone:712-527-2823
Mailing Address - Fax:712-527-4193
Practice Address - Street 1:1720 N 16TH ST STE K
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51501-0109
Practice Address - Country:US
Practice Address - Phone:715-527-2823
Practice Address - Fax:712-527-4193
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-26
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA174960363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner