Individual
CYNTHIA J COUNTRYMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
6940 MICHIGAN RD, SUITE 140, INDIANAPOLIS, IN 46268-2800
(317) 266-2901
(317) 266-2916
Mailing address
8910 PURDUE RD, SUITE 500, INDIANAPOLIS, IN 46268-3161
(317) 871-8811
(317) 871-8833
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71001936A
IN
363L00000X
Nurse Practitioner
AP 60167721
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200866670
—
IN
Enumeration date
06/15/2007
Last updated
12/27/2021
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