Healthcare Provider Details
I. General information
NPI: 1245553080
Provider Name (Legal Business Name): CYNTHIA DENISE PERRYMAN RN-BSN CRRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/08/2010
Last Update Date: 03/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
127 FOREST GLEN DR
WARM SPRINGS GA
31830-2299
US
IV. Provider business mailing address
127 FOREST GLEN DR
WARM SPRINGS GA
31830-2299
US
V. Phone/Fax
- Phone: 706-573-8162
- Fax:
- Phone: 706-573-8162
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | RN165196 |
| License Number State | GA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WA2000X |
| Taxonomy | Administrator Registered Nurse |
| License Number | RN165196 |
| License Number State | GA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WH0200X |
| Taxonomy | Home Health Registered Nurse |
| License Number | RN165196 |
| License Number State | GA |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WP0809X |
| Taxonomy | Adult Psychiatric/Mental Health Registered Nurse |
| License Number | RN165196 |
| License Number State | GA |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WR0400X |
| Taxonomy | Rehabilitation Registered Nurse |
| License Number | RN165196 |
| License Number State | GA |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WX0800X |
| Taxonomy | Orthopedic Registered Nurse |
| License Number | 1-117828 |
| License Number State | AL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: