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General NPI Number Information
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NPI Number | 1922384957
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Entity Type | Individual
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Provider Name | CYNTHIA MARIE VENTRE CRNP
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Gender | Female
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Dates
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Enumeration Date | 10/21/2011
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Last Update Date | 09/08/2016
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Provider Practice Location Address
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Address Line | 203 RODENBACH LANE
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City | BRODHEADSVILLE
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State | PA
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Zip | 18322-9900
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Country | US
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Telephone | 570-992-4208
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Fax | 570-992-6117
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Provider Business Mailing Address
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Address Line | 801 OSTRUM ST
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City | BETHLEHEM
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State | PA
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Zip | 18015-1000
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Country | US
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Telephone | 484-526-6048
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Fax | 484-526-6500
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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 | SP011703
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License Number State | PA
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