Individual provider Active NPI

Cynthia Gail Northrup

  • Licensed Practical Nurse
  • Evanston, WY
National Provider Identifier
1093009326
Registry record updated Jun 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
3572 Issued in WY
Practice address
350 City View Dr
Ste 302
Evanston, WY 82930-5327
Phone
(307) 789-7915
Fax
(307) 789-6009
NPI assigned
Jun 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 3572 WY Primary

Addresses

Primary practice location

350 City View Dr
Ste 302
Evanston, WY 82930-5327

Mailing address

350 City View Dr
Ste 302
Evanston, WY 82930-5327
Phone (307) 789-7915

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3572WYMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1307059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307059200000",
    "number": "1093009326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 CITY VIEW DR",
            "address_2": "STE 302",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829305327",
            "telephone_number": "307-789-7915",
            "fax_number": "307-789-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 CITY VIEW DR",
            "address_2": "STE 302",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829305327",
            "telephone_number": "307-789-7915",
            "fax_number": "307-789-6009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTHRUP",
        "first_name": "CYNTHIA",
        "middle_name": "GAIL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-03",
        "last_updated": "2011-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WY",
            "license": "3572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.