Provider Demographics
NPI:1588783724
Name:BLUE, CYNTHIA ANN (RN)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:ANN
Last Name:BLUE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9460 E SUMMER TRL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85749-8288
Mailing Address - Country:US
Mailing Address - Phone:520-731-3847
Mailing Address - Fax:
Practice Address - Street 1:450 S MONTEGO DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-3796
Practice Address - Country:US
Practice Address - Phone:520-731-3847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN125208163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ856479Medicaid