Provider Demographics
NPI:1538882642
Name:PURDY, CYNTHIA JANE (RN)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:JANE
Last Name:PURDY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:J
Other - Last Name:SALISBURY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:15 OSPREY CIR
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-8897
Mailing Address - Country:US
Mailing Address - Phone:707-332-8696
Mailing Address - Fax:
Practice Address - Street 1:15 OSPREY CIR
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-8897
Practice Address - Country:US
Practice Address - Phone:707-332-8696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-22
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA429679163W00000X, 163WC0400X, 163WG0600X, 163WH0200X, 163WW0000X, 163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WG0600XNursing Service ProvidersRegistered NurseGerontology
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC0164137OtherDEPT. OF MOTOR VEHICLES
CA429679OtherBOARD OF REGISTERED NURSING