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General NPI Number Information
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NPI Number | 1144025800
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Entity Type | Individual
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Provider Name | CYNTHIA L SUTTON-SHAW
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Gender | Female
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Dates
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Enumeration Date | 02/17/2025
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Last Update Date | 02/17/2025
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Provider Practice Location Address
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Address Line | 2050 COUNTY ROAD 59
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City | ALLIANCE
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State | NE
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Zip | 69301-5864
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Country | US
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Telephone | 308-760-1101
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Fax |
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Provider Business Mailing Address
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Address Line | 1108 SECOND STREET PO BOX 631
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City | BRIDGEPORT
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State | NE
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Zip | 69336
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Country | US
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Telephone | 308-249-2535
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Fax |
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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 | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 372500000X
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Taxonomy Name | Chore Provider
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License Number |
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License Number State |
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