Individual
CYNTHIA A SAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, APRN
Contact information
Practice address
530 N MONTE VISTA ST STE A, ADA, OK 74820-4675
(580) 310-9510
Mailing address
PO BOX 358, KREBS, OK 74554-0358
(918) 424-9684
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
02009
NM
363LF0000X
Family Nurse Practitioner
75026
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
271777YM5A
MEDICARE
NM
05
—
91531551
—
NM
Enumeration date
09/26/2008
Last updated
06/20/2024
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