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General NPI Number Information
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NPI Number | 1588623573
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Entity Type | Individual
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Provider Name | CYNTHIA J MODLIN-ADAMS RN MSN ANP BC BYANCC
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Gender | Female
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Dates
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Enumeration Date | 03/20/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1501 HARTFORD ST
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City | LAFAYETTE
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State | IN
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Zip | 47904-2134
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Country | US
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Telephone | 765-446-4838
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Fax | 765-446-4851
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Provider Business Mailing Address
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Address Line | 1501 HARTFORD ST
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City | LAFAYETTE
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State | IN
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Zip | 47904-2134
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Country | US
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Telephone | 765-446-4838
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Fax | 765-446-4851
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN28084777A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | NP71000092A
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License Number State | IN
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