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General NPI Number Information
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NPI Number | 1689681942
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Entity Type | Individual
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Provider Name | CYNTHIA PEARSON FNP
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Gender | Female
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 06/29/2012
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Provider Practice Location Address
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Address Line | 123 ALCORN DR
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City | CORINTH
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State | MS
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Zip | 38834-9359
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Country | US
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Telephone | 662-286-2866
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Fax | 662-286-2864
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Provider Business Mailing Address
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Address Line | P.O. BOX 298
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City | FLORENCE
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State | AL
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Zip | 35631-0298
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Country | US
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Telephone | 256-767-7494
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Fax | 256-765-0377
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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 | R851921
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License Number State | MS
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