=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861684813
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CYNTHIA MARIE STROUD R.N.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/14/2007
-----------------------------------------------------
Last Update Date | 08/14/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 492 KING CREEK BLVD SUITE B
-----------------------------------------------------
City | HENDERSONVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28792-4933
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-699-6561
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 817
-----------------------------------------------------
City | FLAT ROCK
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28731-0817
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-699-6561
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 125709
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------