Provider Demographics
NPI:1407428667
Name:ZWICK, CYENTHIA LAVONE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:CYENTHIA
Middle Name:LAVONE
Last Name:ZWICK
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 70184
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31708-0184
Mailing Address - Country:US
Mailing Address - Phone:229-446-9000
Mailing Address - Fax:
Practice Address - Street 1:1826 VETERANS BLVD BLDG 87
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-3620
Practice Address - Country:US
Practice Address - Phone:229-446-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-15
Last Update Date:2024-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9433970163W00000X
GARN107169163W00000X, 363LP0808X
FL11014238363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse