Provider Demographics
NPI:1336424522
Name:DAY, CYNTHIA DIANNE (NP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:DIANNE
Last Name:DAY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 EAST VILLANOW STREET
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:GA
Mailing Address - Zip Code:30728
Mailing Address - Country:US
Mailing Address - Phone:706-638-1606
Mailing Address - Fax:706-638-9987
Practice Address - Street 1:611 EAST VILLANOW STREET
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:GA
Practice Address - Zip Code:30728
Practice Address - Country:US
Practice Address - Phone:706-638-1606
Practice Address - Fax:706-638-9987
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN122559363LF0000X
TNAPN16089363LF0000X
TN16089363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily