Provider Demographics
NPI:1972792737
Name:CAMPOS, CYNTHIA (FNP-C)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:
Last Name:CAMPOS
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 1:110 MESA PARK DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-6159
Mailing Address - Country:US
Mailing Address - Phone:915-351-7546
Mailing Address - Fax:915-351-3545
Practice Address - Street 1:110 MESA PARK DR
Practice Address - Street 2:SUITE 100
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-6159
Practice Address - Country:US
Practice Address - Phone:915-351-7546
Practice Address - Fax:915-351-3545
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX666228363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily