Provider Demographics
NPI:1063091171
Name:LALUZERNE, CYNTHIA ANN (APNP)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ANN
Last Name:LALUZERNE
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:ANN
Other - Last Name:FARRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APNP
Mailing Address - Street 1:323 S 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:STURGEON BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54235-1401
Mailing Address - Country:US
Mailing Address - Phone:920-743-5566
Mailing Address - Fax:
Practice Address - Street 1:815 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:ALGOMA
Practice Address - State:WI
Practice Address - Zip Code:54201-1733
Practice Address - Country:US
Practice Address - Phone:920-487-3496
Practice Address - Fax:920-487-0275
Is Sole Proprietor?:No
Enumeration Date:2021-04-06
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10522363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
F06202416OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS