Provider Demographics
NPI:1669111258
Name:DULANEY, CINDY LEE (FNP-BC)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:LEE
Last Name:DULANEY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 HIGHWAY D
Mailing Address - Street 2:
Mailing Address - City:FREDERICKTOWN
Mailing Address - State:MO
Mailing Address - Zip Code:63645-7720
Mailing Address - Country:US
Mailing Address - Phone:573-783-1868
Mailing Address - Fax:
Practice Address - Street 1:1201 HIGHWAY D
Practice Address - Street 2:
Practice Address - City:FREDERICKTOWN
Practice Address - State:MO
Practice Address - Zip Code:63645-7720
Practice Address - Country:US
Practice Address - Phone:573-783-1868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022009274363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily