Provider Demographics
NPI:1174570626
Name:NUNAN, CINDY (NP)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:NUNAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 E. NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08244
Mailing Address - Country:US
Mailing Address - Phone:609-653-3265
Mailing Address - Fax:609-926-4311
Practice Address - Street 1:4450 E. BLACK HORSE PIKE
Practice Address - Street 2:UNIT 3972
Practice Address - City:MAYS LANDING
Practice Address - State:NJ
Practice Address - Zip Code:08330
Practice Address - Country:US
Practice Address - Phone:609-365-6217
Practice Address - Fax:609-926-4311
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-30
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00101900363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0091618Medicaid
NJ0091618Medicaid
097730SBVMedicare PIN
NJ097730CN9Medicare PIN
NJ097730UKEMedicare PIN
NJ097730DR7Medicare PIN
NJ097730N4XMedicare PIN