Healthcare Provider Details

I. General information

NPI: 1407428667
Provider Name (Legal Business Name): CYENTHIA LAVONE ZWICK PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2021
Last Update Date: 05/11/2024
Certification Date: 05/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1826 VETERANS BLVD BLDG 87
DUBLIN GA
31021-3620
US

IV. Provider business mailing address

PO BOX 70184
ALBANY GA
31708-0184
US

V. Phone/Fax

Practice location:
  • Phone: 229-446-9000
  • Fax:
Mailing address:
  • Phone: 229-446-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11014238
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN107169
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9433970
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN107169
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: