Gorrell, Cynthia K

Gorrell, Cynthia K is an individual health care provider with primary practice located at 7956 W Jefferson Blvd , Fort Wayne IN 46804-4140. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Gorrell, Cynthia K can be contacted via phone (260) 435-6722.

Contact Information

Primary practice address
7956 W Jefferson Blvd Fort Wayne IN 46804-4140
Fax: (260) 435-6726
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 71000946A Indiana

Profile Details

NPI number 1316932734
LBN Legal business name Gorrell, Cynthia K
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 12th, 2005
Last updated Oct 7th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316932734 NPPES
Indiana MEDICAID 200201500
Indiana MEDICAID 200945140
Indiana Other 000000675816

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