Healthcare Provider Details

I. General information

NPI: 1982935581
Provider Name (Legal Business Name): CYNTHIA A. PENDLUM RNC, WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2010
Last Update Date: 01/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 N STATE ST
GREENFIELD IN
46140-1270
US

IV. Provider business mailing address

801 N STATE ST
GREENFIELD IN
46140-1270
US

V. Phone/Fax

Practice location:
  • Phone: 317-468-4602
  • Fax: 317-468-4102
Mailing address:
  • Phone: 317-468-4602
  • Fax: 317-468-4102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number28088870A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: