Healthcare Provider Details
I. General information
NPI: 1902916125
Provider Name (Legal Business Name): CINDY F HUANG FNP; PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
729 BROADWAY ST
QUINCY IL
62301-2708
US
IV. Provider business mailing address
729 BROADWAY ST
QUINCY IL
62301-2708
US
V. Phone/Fax
- Phone: 217-228-0252
- Fax:
- Phone: 217-228-0252
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: