Healthcare Provider Details

I. General information

NPI: 1831433788
Provider Name (Legal Business Name): CYNTHIA R RAY CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2012
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7002 ARUNDEL MILLS CIR STE 7777
HANOVER MD
21076-1280
US

IV. Provider business mailing address

11106 QUEENS WOOD TER
BOWIE MD
20721-2217
US

V. Phone/Fax

Practice location:
  • Phone: 443-445-2498
  • Fax:
Mailing address:
  • Phone: 812-345-8933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR200559
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: