Provider Demographics
NPI:1912940370
Name:COFFELT-WHISENANT, CYNTHIA LYNN (DNP, APRN, FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:LYNN
Last Name:COFFELT-WHISENANT
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5211 W 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-4120
Mailing Address - Country:US
Mailing Address - Phone:806-356-0026
Mailing Address - Fax:806-358-3114
Practice Address - Street 1:5211 W 9TH AVE
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-4120
Practice Address - Country:US
Practice Address - Phone:806-356-0026
Practice Address - Fax:806-358-3114
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX594083363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
584937Medicare UPIN
TX584957Medicare UPIN