Provider Demographics
NPI:1700022217
Name:GLIDEWELL, CYNTHIA GAY (RN BS)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:GAY
Last Name:GLIDEWELL
Suffix:
Gender:F
Credentials:RN BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 OFARRELL ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-1386
Mailing Address - Country:US
Mailing Address - Phone:650-645-1100
Mailing Address - Fax:
Practice Address - Street 1:1900 OFARRELL ST
Practice Address - Street 2:SUITE 250
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-1386
Practice Address - Country:US
Practice Address - Phone:650-645-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-05
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR20739163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse