Individual
CYNTHIA MARCUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
902 S JEFFERSON ST, ROANOKE, VA 24016-4404
(540) 985-9862
Mailing address
5122 BRITANEY RD, ROANOKE, VA 24012-8505
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024-164668
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010116830
—
VA
05
—
1528034089
—
VA
Enumeration date
02/24/2006
Last updated
11/04/2008
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