Provider Demographics
NPI:1427478742
Name:WANSLEY, CYNTHIA HEMPHILL (RPH)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:HEMPHILL
Last Name:WANSLEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3886 HIGHWAY 17
Mailing Address - Street 2:
Mailing Address - City:TOCCOA
Mailing Address - State:GA
Mailing Address - Zip Code:30577
Mailing Address - Country:US
Mailing Address - Phone:706-282-1193
Mailing Address - Fax:706-886-9695
Practice Address - Street 1:3886 GEORGIA HIGHWAY 17
Practice Address - Street 2:
Practice Address - City:TOCCOA
Practice Address - State:GA
Practice Address - Zip Code:30577
Practice Address - Country:US
Practice Address - Phone:706-282-1193
Practice Address - Fax:706-886-9695
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-25
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH014733183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist