MEDICARE: MRS. CYNTHIA A CUPERO R. N. BSN

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	163WS0200X	School Registered Nurse	RN099668	AZ

General Provider Information

NPI Number	:	1982724290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CYNTHIA A CUPERO R. N. BSN

Provider Business Mailing Address
First Line	:	5316 W MOHAWK LN
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85308-9311
Country	:	US
Telephone Number	:	623-362-2824
Fax Number	:

Provider Business Practice Location Address
First Line	:	7000 W HAPPY VALLEY RD
Second Line	:
City	:	PEORIA
State	:	AZ
Zip	:	85383-3278
Country	:	US
Telephone Number	:	623-445-7610
Fax Number	:

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

Provider Enumeration Date	:	03/30/2007
Last Update Date	:	07/08/2007

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