Provider Demographics
NPI:1811705387
Name:OHONBA, CYNTHIA (NP)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:OHONBA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:743 MILLER VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-1813
Mailing Address - Country:US
Mailing Address - Phone:928-777-9600
Mailing Address - Fax:855-449-5560
Practice Address - Street 1:743 MILLER VALLEY RD
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-1813
Practice Address - Country:US
Practice Address - Phone:928-777-9600
Practice Address - Fax:855-449-5560
Is Sole Proprietor?:No
Enumeration Date:2024-12-30
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN317290363LP0808X
AZ317290363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health