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General NPI Number Information
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NPI Number | 1104238963
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Entity Type | Individual
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Provider Name | CYNTHIA ANN VENECIA FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 05/28/2014
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Last Update Date | 08/19/2024
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Provider Practice Location Address
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Address Line | 1150 FOSTER AVE
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City | ARCATA
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State | CA
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Zip | 95521-5986
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Country | US
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Telephone | 707-822-2481
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Fax | 707-826-8623
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Provider Business Mailing Address
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Address Line | 1150 FOSTER AVE
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City | ARCATA
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State | CA
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Zip | 95521-5986
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Country | US
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Telephone | 707-826-8610
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Fax | 707-826-8623
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP125441
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95028409
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License Number State | CA
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