Basic Information
Provider Information
NPI: 1043469489
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KAPPLER
FirstName: CYNTHIA
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1613 HARRISON PKWY
Address2: SUITE 200
City: SUNRISE
State: FL
PostalCode: 333232896
CountryCode: US
TelephoneNumber: 9548382588
FaxNumber: 9548511758
Practice Location
Address1: 1710 HARPER RD
Address2:  
City: BECKLEY
State: WV
PostalCode: 258013357
CountryCode: US
TelephoneNumber: 3042564100
FaxNumber: 9548511758
Other Information
ProviderEnumerationDate: 09/10/2008
LastUpdateDate: 04/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/21/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X52620WVY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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