Provider Demographics
NPI:1932151271
Name:PREIS, CYNTHIA J (APRN)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:J
Last Name:PREIS
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 1:809 MARTIN LUTHER KING JR DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70501-1884
Mailing Address - Country:US
Mailing Address - Phone:337-233-2437
Mailing Address - Fax:337-235-4178
Practice Address - Street 1:809 MARTIN LUTHER KING JR DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70501-1884
Practice Address - Country:US
Practice Address - Phone:337-233-2437
Practice Address - Fax:337-235-4178
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP01825364SP0809X, 363LF0000X, 364SP0809X
MNR199781-1364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1699501Medicaid
LA1699501Medicaid
LA1699501Medicaid