Provider Demographics
NPI:1649260258
Name:HILE, CYNTHIA ANNE (PAC)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ANNE
Last Name:HILE
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:MISS
Other - First Name:CYNTHIA
Other - Middle Name:ANNE
Other - Last Name:HORSTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3733 SIMPSON TRCE
Mailing Address - Street 2:
Mailing Address - City:MAINEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45039-9577
Mailing Address - Country:US
Mailing Address - Phone:513-677-3647
Mailing Address - Fax:
Practice Address - Street 1:3733 SIMPSON TRCE
Practice Address - Street 2:
Practice Address - City:MAINEVILLE
Practice Address - State:OH
Practice Address - Zip Code:45039-9577
Practice Address - Country:US
Practice Address - Phone:513-677-3647
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50-00-0590363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000376514OtherANTHEM
OHS65649Medicare UPIN
OHHIPA12404Medicare ID - Type Unspecified