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Individual

CYNTHIA ANN MAYBERRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
705 E LAHARPE ST STE D, KIRKSVILLE, MO 63501-4526
(660) 665-3545
(660) 665-3226
Mailing address
705 E LAHARPE ST STE D, KIRKSVILLE, MO 63501-4526
(660) 665-3545
(660) 665-3226

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
100516
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
182570
BLUE CROSS/BLUE SHIELD
MO
05
429173503
MO
01
633829
COM
Enumeration date
07/07/2006
Last updated
10/09/2012
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