Provider Demographics
NPI:1477132256
Name:NEWCOMB, CYNTHIA ANNE (RN)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:ANNE
Last Name:NEWCOMB
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 KODIAK ST
Mailing Address - Street 2:
Mailing Address - City:MORRO BAY
Mailing Address - State:CA
Mailing Address - Zip Code:93442-1315
Mailing Address - Country:US
Mailing Address - Phone:530-957-8585
Mailing Address - Fax:
Practice Address - Street 1:431 KODIAK ST
Practice Address - Street 2:
Practice Address - City:MORRO BAY
Practice Address - State:CA
Practice Address - Zip Code:93442-1315
Practice Address - Country:US
Practice Address - Phone:530-957-8585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550988163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse