Provider Demographics
NPI:1184710956
Name:MCCREADY, CYNTHIA MATTSON (CRNP)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:MATTSON
Last Name:MCCREADY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5439 E NITHSDALE DR
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-2462
Mailing Address - Country:US
Mailing Address - Phone:410-543-4538
Mailing Address - Fax:
Practice Address - Street 1:1101 CAMDEN AVE
Practice Address - Street 2:HOLLOWAY HALL RM 180
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-6860
Practice Address - Country:US
Practice Address - Phone:410-543-6262
Practice Address - Fax:410-548-4101
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR077019363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner