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General NPI Number Information
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NPI Number | 1245456623
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Entity Type | Individual
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Provider Name | CYNTHIA D PETIT MSN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 01/06/2017
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Provider Practice Location Address
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Address Line | 7917 BELGARO RD
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City | LAUREL
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State | MD
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Zip | 20723-1108
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Country | US
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Telephone | 240-472-4949
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Fax |
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Provider Business Mailing Address
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Address Line | 7917 BELGARO RD
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City | LAUREL
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State | MD
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Zip | 20723-1108
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Country | US
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Telephone | 301-483-0299
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R150399
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License Number State | MD
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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 | 0024172564
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License Number State | VA
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