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Individual

MS. CINDY MARIE ROSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
1381 ROUTE 31, MEMPHIS, NY 13027
(315) 689-5027
Mailing address
178 GOODFELLOW LANE, BALDWINSVILLE, NY 13027
(315) 635-8538

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
260069-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02411205
NY
Enumeration date
05/07/2007
Last updated
07/09/2007
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