Healthcare Provider Details

I. General information

NPI: 1700841293
Provider Name (Legal Business Name): CYNTHIA WALTER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CYNTHIA S WALTER RN CRNP

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 04/23/2020
Certification Date: 04/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 SUNSET DRIVE SUITE 2
BUTLER PA
16001
US

IV. Provider business mailing address

PO BOX 3510
PITTSBURGH PA
15230-3510
US

V. Phone/Fax

Practice location:
  • Phone: 724-282-2730
  • Fax: 724-282-3004
Mailing address:
  • Phone: 724-282-2730
  • Fax: 724-282-3004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN299817L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberVP003306G
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: