Cynthia Carol Noll, C-FNP
Individual provider Active NPI Family Nurse Practitioner · Havana, IL
NPI 1992831614 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1992831614
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- Practice address
- 615 N Promenade St
Havana, IL 62644-1243 - Phone
- (309) 543-6600
- Fax
- (309) 543-2089
- NPI assigned
- Feb 26, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141020001542 | IL | Order and Referring Only - Nurse Practitioner | 9537247945 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041239257 | IL | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | IL | Yes |
Addresses
Primary practice location
615 N Promenade St
Havana, IL 62644-1243
Mailing address
615 N Promenade St
P O Box 530
Havana, IL 62644-1243
Phone (309) 543-6600
Other providers in Havana, IL
- Mason Hospital District
- Mason Hospital District
- Mason Hospital District
- Kayla R Miller
- Nathan Lee Moehring
- Stanley Jay Noll
- Robert Edward Olt
- Pam Herrick Counseling, S.C.
- Petersen Health Care Inc
- Jessica Poling
All providers in Havana, IL · Family Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.