Provider Demographics
NPI:1780925958
Name:TOMPKINS, CYNTHIA LU (RN, CNP)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:LU
Last Name:TOMPKINS
Suffix:
Gender:F
Credentials:RN, CNP
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:LU
Other - Last Name:KREZEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8170 33RD AVE S # MS 21110Q
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:651-254-7980
Mailing Address - Fax:952-853-8727
Practice Address - Street 1:640 JACKSON ST # MS 11502V
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-2502
Practice Address - Country:US
Practice Address - Phone:651-254-7980
Practice Address - Fax:651-254-7990
Is Sole Proprietor?:No
Enumeration Date:2013-03-12
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN124800-1363LA2200X
MN0380363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health