Provider Demographics
NPI:1396796488
Name:DABNEY, CYNTHIA (CRNA)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:
Last Name:DABNEY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:PONTONI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:877 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-2807
Mailing Address - Country:US
Mailing Address - Phone:901-545-6286
Mailing Address - Fax:901-545-8122
Practice Address - Street 1:877 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-2807
Practice Address - Country:US
Practice Address - Phone:901-545-6286
Practice Address - Fax:901-545-8122
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-13
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN 135247163W00000X
TNAPN 10927367500000X
FLAPRN11017782367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN430076108OtherRAILROAD MEDICARE
TN3631412Medicaid
AR148161701Medicaid
TN4033935OtherBLUE CROSS
MS00126508Medicaid
AR99515OtherBLUE CROSS
AR148161701Medicaid