MEDICARE: CYNTHIA JEAN FIESTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	125565	IA

General Provider Information

NPI Number	:	1093372062
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA JEAN FIESTER

Provider Business Mailing Address
First Line	:	3701 ELMWOOD DR NE
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52402-2708
Country	:	US
Telephone Number	:	319-560-6339
Fax Number	:

Provider Business Practice Location Address
First Line	:	3701 ELMWOOD DR NE
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52402-2708
Country	:	US
Telephone Number	:	319-560-6339
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2019
Last Update Date	:	05/23/2019

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Directions to “ CYNTHIA JEAN FIESTER ” Practice Location

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