Provider Demographics
NPI:1174594600
Name:EDWARDS, CYNTHIA J (CRNA)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:J
Last Name:EDWARDS
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Gender:F
Credentials:CRNA
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Mailing Address - Street 1:20 MEDICAL VILLAGE DRIVE SUITE 258
Mailing Address - Street 2:MILLENIUM ANESTHESIA LLC
Mailing Address - City:EDGEWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:41017
Mailing Address - Country:US
Mailing Address - Phone:859-341-7246
Mailing Address - Fax:859-341-7867
Practice Address - Street 1:311 STRAIGHT STREET
Practice Address - Street 2:MILLENIUM ANESTHESIA LLC
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219
Practice Address - Country:US
Practice Address - Phone:859-341-7246
Practice Address - Fax:859-341-7867
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2008-02-28
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Provider Licenses
StateLicense IDTaxonomies
OH107634367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0809012Medicaid
727942OtherBUCKEYE
000000194388OtherANTHEM BLUE SHIELD
KY74006156Medicaid
KY74006156Medicaid