Healthcare Provider Details

I. General information

NPI: 1407842925
Provider Name (Legal Business Name): CINDY MAENO CALDWELL FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 12/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 N SLAPPEY BLVD
ALBANY GA
31701-1413
US

IV. Provider business mailing address

701 N SLAPPEY BLVD
ALBANY GA
31701-1413
US

V. Phone/Fax

Practice location:
  • Phone: 229-430-6061
  • Fax: 229-430-6002
Mailing address:
  • Phone: 229-430-6061
  • Fax: 229-430-6002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN115517
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: