Provider Demographics
NPI:1982743365
Name:JOHNSON SMITH, CYNTHIA D (RNC NP)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:D
Last Name:JOHNSON SMITH
Suffix:
Gender:F
Credentials:RNC NP
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Mailing Address - Street 1:1010 MASSACHUSETTS AVENUE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118
Mailing Address - Country:US
Mailing Address - Phone:617-534-2398
Mailing Address - Fax:617-534-4688
Practice Address - Street 1:240 MEDFORD AVE
Practice Address - Street 2:CHARLESTOWN HIGH SCHOOL
Practice Address - City:CHARLESTOWN
Practice Address - State:MA
Practice Address - Zip Code:02129
Practice Address - Country:US
Practice Address - Phone:617-534-9957
Practice Address - Fax:617-534-9956
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MA115301363LS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LS0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerSchool