MEDICARE: MRS. CINDY L ROSS MS, BCHN, CNP

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	133NN1002X	Nutrition Education Nutritionist

General Provider Information

NPI Number	:	1730777251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CINDY L ROSS MS, BCHN, CNP

Provider Business Mailing Address
First Line	:	30365 ONO NORTH LOOP W
Second Line	:
City	:	ORANGE BEACH
State	:	AL
Zip	:	36561-5717
Country	:	US
Telephone Number	:	251-635-7477
Fax Number	:

Provider Business Practice Location Address
First Line	:	30365 ONO NORTH LOOP W
Second Line	:
City	:	ORANGE BEACH
State	:	AL
Zip	:	36561-5717
Country	:	US
Telephone Number	:	251-949-2220
Fax Number	:

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

Provider Enumeration Date	:	01/10/2021
Last Update Date	:	01/10/2021

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