Basic Information
| Provider Information | |||||||||
| NPI: | 1851304232 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MATHEWS | ||||||||
| FirstName: | CYNTHIA | ||||||||
| MiddleName: | POIRE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8 BLUE JAY LN | ||||||||
| Address2: | |||||||||
| City: | CAMPTON | ||||||||
| State: | NH | ||||||||
| PostalCode: | 032234745 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6035362502 | ||||||||
| FaxNumber: | 6035362503 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 WARREN ST | ||||||||
| Address2: | |||||||||
| City: | PLYMOUTH | ||||||||
| State: | NH | ||||||||
| PostalCode: | 032641416 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6035362502 | ||||||||
| FaxNumber: | 6035362503 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 0214672303 | NH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 30010067 | 05 | NH | MEDICAID | 2304012YPN401 | 01 | NH | ANTHEM | OTHER |