Provider Demographics
NPI:1700898368
Name:WARE, CYNTHIA (APRN)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:WARE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:284 BEACON HILL LN
Mailing Address - Street 2:
Mailing Address - City:FISHERVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40023-6488
Mailing Address - Country:US
Mailing Address - Phone:502-295-7424
Mailing Address - Fax:
Practice Address - Street 1:284 BEACON HILL LN
Practice Address - Street 2:
Practice Address - City:FISHERVILLE
Practice Address - State:KY
Practice Address - Zip Code:40023-6488
Practice Address - Country:US
Practice Address - Phone:502-295-7424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3002839363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1164657OtherPASSPORT
IN200399710Medicaid
KY000000232256OtherANTHEM
KY2439863000OtherPASSPORT ADVANTAGE
KY78008125Medicaid
KYP65112Medicare UPIN
KY2439863000OtherPASSPORT ADVANTAGE
KY0097189Medicare PIN