Provider Demographics
NPI:1285063255
Name:CLEARY, CYNTHIA STUMPF (PA-C)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:STUMPF
Last Name:CLEARY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2046 CREEKSIDE LANDING DR
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-3982
Mailing Address - Country:US
Mailing Address - Phone:919-303-4777
Mailing Address - Fax:919-303-0077
Practice Address - Street 1:2046 CREEKSIDE LANDING DR
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-3982
Practice Address - Country:US
Practice Address - Phone:919-303-4777
Practice Address - Fax:919-303-0077
Is Sole Proprietor?:No
Enumeration Date:2013-11-11
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC001007922363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant