MEDICARE: CYNTHIA MARIE VENTRE 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	363L00000X	Nurse Practitioner	SP011703	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	003943	OTHER	PA	MEDICARE GROUP

General Provider Information

NPI Number	:	1922384957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA MARIE VENTRE CRNP

Provider Business Mailing Address
First Line	:	801 OSTRUM ST
Second Line	:
City	:	BETHLEHEM
State	:	PA
Zip	:	18015-1000
Country	:	US
Telephone Number	:	484-526-6048
Fax Number	:	484-526-6500

Provider Business Practice Location Address
First Line	:	111 ROUTE 715
Second Line	:
City	:	BRODHEADSVILLE
State	:	PA
Zip	:	18322-7101
Country	:	US
Telephone Number	:	272-212-0435
Fax Number	:	866-230-8056

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

Provider Enumeration Date	:	10/21/2011
Last Update Date	:	06/02/2026

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