Provider Demographics
NPI:1578007563
Name:WINDOM, CIDNEY CHESTER (FNP-C)
Entity type:Individual
Prefix:
First Name:CIDNEY
Middle Name:CHESTER
Last Name:WINDOM
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 WEST ST NW
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30014-2173
Mailing Address - Country:US
Mailing Address - Phone:770-787-0211
Mailing Address - Fax:
Practice Address - Street 1:5100 WEST ST NW
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-2173
Practice Address - Country:US
Practice Address - Phone:770-787-0211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-08
Last Update Date:2025-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN222883363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily