MEDICARE: CYNTHIA N. MASSEY CRNP

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	363LA2100X	Acute Care Nurse Practitioner	1-035660	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	51542085	OTHER	AL	BCBS

General Provider Information

NPI Number	:	1669515250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA N. MASSEY CRNP

Provider Business Mailing Address
First Line	:	100 PILOT MEDICAL DR
Second Line	:	#300
City	:	BIRMINGHAM
State	:	AL
Zip	:	35235-3411
Country	:	US
Telephone Number	:	205-856-2284
Fax Number	:	205-815-4864

Provider Business Practice Location Address
First Line	:	100 PILOT MEDICAL DR
Second Line	:	#300
City	:	BIRMINGHAM
State	:	AL
Zip	:	35235-3411
Country	:	US
Telephone Number	:	205-856-2284
Fax Number	:	205-815-4864

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

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	01/14/2010

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Practice Location Address:

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