Individual
CYNTHIA J BOOTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P.
Contact information
Practice address
436 CLAIRMONT CT, SUITE 100, COLONIAL HEIGHTS, VA 23834-1765
(804) 526-2121
(804) 520-2617
Mailing address
436 CLAIRMONT CT, SUITE 100, COLONIAL HEIGHTS, VA 23834-1765
(804) 526-2121
(804) 520-2617
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
007138155
VA
363L00000X
Nurse Practitioner
Primary
0024166276
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003989351
NPI
VA
01
—
11657718
CAQH
—
Enumeration date
11/16/2006
Last updated
02/20/2015
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