Provider Demographics
NPI:1588904221
Name:WITT, CYNTHIA (NP-C)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:WITT
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1800 NORTHSIDE FORSYTH DR
Mailing Address - Street 2:SUITE 380
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-8416
Mailing Address - Country:US
Mailing Address - Phone:770-292-2670
Mailing Address - Fax:770-292-2671
Practice Address - Street 1:1726 GUNBARREL RD STE 200
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-4754
Practice Address - Country:US
Practice Address - Phone:423-899-6511
Practice Address - Fax:423-899-6511
Is Sole Proprietor?:No
Enumeration Date:2013-02-17
Last Update Date:2020-10-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA165405363LF0000X
TN17395363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily