Provider Demographics
NPI:1740467539
Name:SEIGEL, CYNTHIA MARIE (FNP)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:MARIE
Last Name:SEIGEL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:
Other - Last Name:SEIGEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1802 DAY RD
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46545-4329
Mailing Address - Country:US
Mailing Address - Phone:574-204-7200
Mailing Address - Fax:574-252-0633
Practice Address - Street 1:1802 DAY RD
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-4329
Practice Address - Country:US
Practice Address - Phone:574-204-7200
Practice Address - Fax:574-252-0633
Is Sole Proprietor?:No
Enumeration Date:2008-01-24
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000931A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201286690Medicaid