Provider Demographics
NPI:1437990207
Name:GRAINGER, CYNDEL RAE (CPM, LM)
Entity type:Individual
Prefix:
First Name:CYNDEL
Middle Name:RAE
Last Name:GRAINGER
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 COLE RD
Mailing Address - Street 2:
Mailing Address - City:KINDER
Mailing Address - State:LA
Mailing Address - Zip Code:70648-6109
Mailing Address - Country:US
Mailing Address - Phone:337-660-8138
Mailing Address - Fax:337-226-3437
Practice Address - Street 1:370 COLE RD
Practice Address - Street 2:
Practice Address - City:KINDER
Practice Address - State:LA
Practice Address - Zip Code:70648-6109
Practice Address - Country:US
Practice Address - Phone:337-660-8138
Practice Address - Fax:337-226-3437
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-04
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA342208176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife