Healthcare Provider Details

I. General information

NPI: 1215752522
Provider Name (Legal Business Name): CYNTHIA MARIE BAYARDO-SACLAYAN REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CYNTHIA BAYARDO

II. Dates (important events)

Enumeration Date: 11/21/2024
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 BRAGAW ST
ANCHORAGE AK
99508-3435
US

IV. Provider business mailing address

1650 BRAGAW ST
ANCHORAGE AK
99508-3435
US

V. Phone/Fax

Practice location:
  • Phone: 907-602-5992
  • Fax:
Mailing address:
  • Phone: 907-602-5992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number193116
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number193116
License Number StateAK
# 3
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number193116
License Number StateAK
# 4
Primary TaxonomyY
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number193116
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: