Provider Demographics
NPI:1366226755
Name:MCBROOM, CYNTHIA (AGACNP-BC)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:
Last Name:MCBROOM
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:
Other - Last Name:MCBROOM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 64
Mailing Address - Street 2:
Mailing Address - City:WADDELL
Mailing Address - State:AZ
Mailing Address - Zip Code:85355-0064
Mailing Address - Country:US
Mailing Address - Phone:602-803-3869
Mailing Address - Fax:
Practice Address - Street 1:7000 N COTTON LN UNIT 64
Practice Address - Street 2:
Practice Address - City:WADDELL
Practice Address - State:AZ
Practice Address - Zip Code:85355-8003
Practice Address - Country:US
Practice Address - Phone:602-803-3869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-24
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ296909363L00000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care