Provider Demographics
NPI:1417686619
Name:MCDONALD, CYNTHIA YVONNE (APRN)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:YVONNE
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:YVONNE
Other - Last Name:SHELTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:103 TALL PINES DR
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-5601
Mailing Address - Country:US
Mailing Address - Phone:502-370-0484
Mailing Address - Fax:
Practice Address - Street 1:301 MCMILLAN RD UNIT 1
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-5323
Practice Address - Country:US
Practice Address - Phone:318-737-7616
Practice Address - Fax:318-855-5158
Is Sole Proprietor?:No
Enumeration Date:2022-06-06
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1086155163W00000X
KY3017955363LF0000X
LA234615363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse