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Individual

CYNTHIA L BOORTZ-MARX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
101 MANNING DR, CHAPEL HILL, NC 27514-4220
(919) 966-6633
(919) 966-4873
Mailing address
101 MANNING DRIVE, CHAPEL HILL, NC 27599
(919) 966-6633
(919) 966-4873

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
212429
NC
367500000X
Certified Registered Nurse Anesthetist
79332
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2618467
MEDICARE
NC
05
44327900
WI
05
NAN626
SC
Enumeration date
06/09/2005
Last updated
01/10/2011
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