Healthcare Provider Details

I. General information

NPI: 1518349653
Provider Name (Legal Business Name): CINDY SINCLAIR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2015
Last Update Date: 06/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 LUJAN HILL RD
LAS CRUCES NM
88007-6304
US

IV. Provider business mailing address

1836 AMBER DR
CARLSBAD NM
88220-4663
US

V. Phone/Fax

Practice location:
  • Phone: 575-523-4573
  • Fax:
Mailing address:
  • Phone: 575-689-7732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA-0652
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: