=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922624774
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CINDY VIERS CNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/17/2020
-----------------------------------------------------
Last Update Date | 05/14/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2458 STETZER RD UNIT A
-----------------------------------------------------
City | BUCYRUS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44820-2066
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-834-8889
-----------------------------------------------------
Fax | 419-525-6723
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 600 W 3RD ST
-----------------------------------------------------
City | MANSFIELD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44906-2633
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | RN.273564
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------