Healthcare Provider Details

I. General information

NPI: 1407500705
Provider Name (Legal Business Name): CYNTHIA ADSON ARNP, FNPBC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2022
Last Update Date: 02/07/2022
Certification Date: 02/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 S YALE ST STE 250
FLAGSTAFF AZ
86001-7336
US

IV. Provider business mailing address

1501 S YALE ST STE 250
FLAGSTAFF AZ
86001-7336
US

V. Phone/Fax

Practice location:
  • Phone: 928-556-0707
  • Fax:
Mailing address:
  • Phone: 928-556-0707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number246176
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: