Healthcare Provider Details

I. General information

NPI: 1396950242
Provider Name (Legal Business Name): CYNTHIA R DREW MS, APRN, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 WYOMING AVE
DOVER DE
19904-6912
US

IV. Provider business mailing address

223 WYOMING AVE
DOVER DE
19904-6912
US

V. Phone/Fax

Practice location:
  • Phone: 302-674-9193
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberLD-0000120
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: