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NPI Code Detail

MEDICARE: MS. CYNTHIA J MODLIN-ADAMS RN MSN ANP BC BYANCC

MEDICARE: MS. CYNTHIA J MODLIN-ADAMS RN MSN ANP BC BYANCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerRN28084777AIN
2363L00000XNurse PractitionerNP71000092AIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4500006273OTHERINRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
19397607OTHERINPHCS PID NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3000000559485OTHERINANTHEM

General Provider Information

NPI Number : 1588623573
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CYNTHIA J MODLIN-ADAMS RN MSN ANP BC BYANCC
Provider Business Mailing Address
First Line : 1501 HARTFORD ST
Second Line :
City : LAFAYETTE
State : IN
Zip : 47904-2134
Country : US
Telephone Number : 765-446-4838
Fax Number : 765-446-4851
Provider Business Practice Location Address
First Line : 1501 HARTFORD ST
Second Line :
City : LAFAYETTE
State : IN
Zip : 47904-2134
Country : US
Telephone Number : 765-446-4838
Fax Number : 765-446-4851
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2006
Last Update Date : 03/07/2023

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