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NPI Code Detail

MEDICARE: CYNTHIA GABRIELLE MOQUIN RN, CNS

MEDICARE: CYNTHIA GABRIELLE MOQUIN RN, CNS
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
1101YM0800XMental Health CounselorRN 436250CA
2101YM0800XMental Health CounselorCNS 1914CA
3163WP0808XPsychiatric/Mental Health Registered Nurse201401150RNOR

General Provider Information

NPI Number : 1164460259
Entity Type Code : Individual
Provider Name (Legal Business Name) : CYNTHIA GABRIELLE MOQUIN RN, CNS
Provider Business Mailing Address
First Line : 36 SW NYE ST
Second Line :
City : NEWPORT
State : OR
Zip : 97365-3821
Country : US
Telephone Number : 541-574-5960
Fax Number : 541-265-0601
Provider Business Practice Location Address
First Line : 51 SW LEE ST
Second Line :
City : NEWPORT
State : OR
Zip : 97365-3823
Country : US
Telephone Number : 541-574-5960
Fax Number : 541-265-0601
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2006
Last Update Date : 07/21/2022

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