Healthcare Provider Details

I. General information

NPI: 1659676039
Provider Name (Legal Business Name): CYNTHIA HUSELTON HUTH CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2011
Last Update Date: 01/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 NOLTE DR
KITTANNING PA
16201-7111
US

IV. Provider business mailing address

1 NOLTE DR
KITTANNING PA
16201-7111
US

V. Phone/Fax

Practice location:
  • Phone: 724-543-8500
  • Fax:
Mailing address:
  • Phone: 724-543-8500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP011181
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: