Provider Demographics
NPI:1306272018
Name:HICKEL, CYNTHIA LYNN (CRNA)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:LYNN
Last Name:HICKEL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 SHADY AVE
Mailing Address - Street 2:APT. #22
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-4823
Mailing Address - Country:US
Mailing Address - Phone:720-235-6876
Mailing Address - Fax:
Practice Address - Street 1:521 SHADY AVE
Practice Address - Street 2:APT. #22
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-4823
Practice Address - Country:US
Practice Address - Phone:720-235-6876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-26
Last Update Date:2014-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN-171905163W00000X
FLRN-174039163W00000X
OH390322163W00000X
AZCRNA0984367500000X
OHCOA.15810-NA367500000X
PARN659011163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse