Provider Demographics
NPI:1295771996
Name:AHLER, CYNTHIA LARAMY (RN CNP)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:LARAMY
Last Name:AHLER
Suffix:
Gender:F
Credentials:RN CNP
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:LARAMY
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:9574 FOLEY BOULEVARD NW
Mailing Address - Street 2:HEAD START BUILDING
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55433
Mailing Address - Country:US
Mailing Address - Phone:763-783-3722
Mailing Address - Fax:763-783-7944
Practice Address - Street 1:9574 FOLEY BOULEVARD NW
Practice Address - Street 2:HEAD START BUILDING
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433
Practice Address - Country:US
Practice Address - Phone:763-783-3722
Practice Address - Fax:763-783-7944
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1316311363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1203356OtherMEDICA
MN31258AHOtherBLUE CROSS BLUE SHIELD
MN31258AHOtherBLUE CROSS BLUE SHIELD