Basic Information
Provider Information
NPI: 1801969811
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SEHR
FirstName: CYNTHIA
MiddleName: LOUISE
NamePrefix: MRS.
NameSuffix:  
Credential: N.P.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 5177
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850105177
CountryCode: US
TelephoneNumber: 6023445651
FaxNumber: 6023445578
Practice Location
Address1: 2601 E ROOSEVELT ST
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850084973
CountryCode: US
TelephoneNumber: 6023445651
FaxNumber: 6023445578
Other Information
ProviderEnumerationDate: 11/16/2006
LastUpdateDate: 12/17/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LN0000XRN057704AZY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal

ID Information
IDTypeStateIssuerDescription
14314705AZ MEDICAID


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