Provider Demographics
NPI:1366286908
Name:DOTSON, CYNTHIA JO (FNP-C)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:JO
Last Name:DOTSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6740 NEW HOPE RD
Mailing Address - Street 2:
Mailing Address - City:BLUEFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:24701-6717
Mailing Address - Country:US
Mailing Address - Phone:304-921-0638
Mailing Address - Fax:
Practice Address - Street 1:365 COURTHOUSE RD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740-2431
Practice Address - Country:US
Practice Address - Phone:304-425-3922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV106475363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily