Provider Demographics
NPI:1932344413
Name:WARDEN, CYNTHIA LYNNE (FNP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:LYNNE
Last Name:WARDEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3734 REYNOLDA RD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-2240
Mailing Address - Country:US
Mailing Address - Phone:336-922-1102
Mailing Address - Fax:336-922-5012
Practice Address - Street 1:290 W WALL ST
Practice Address - Street 2:
Practice Address - City:RURAL HALL
Practice Address - State:NC
Practice Address - Zip Code:27045-9308
Practice Address - Country:US
Practice Address - Phone:336-969-9158
Practice Address - Fax:336-969-4554
Is Sole Proprietor?:No
Enumeration Date:2008-12-11
Last Update Date:2024-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIF0608245363LF0000X
NC5007544363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily