Provider Demographics
NPI:1134597362
Name:RISTINE-BURNLEY, CYNTHIA A (CRNP)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:A
Last Name:RISTINE-BURNLEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 513
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-0513
Mailing Address - Country:US
Mailing Address - Phone:610-256-7181
Mailing Address - Fax:
Practice Address - Street 1:1310 BRIDGEVILLE HWY
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-1617
Practice Address - Country:US
Practice Address - Phone:302-394-6051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-03
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014820363L00000X, 363LF0000X
DELG-0001159363LF0000X
NJ26NJ00849300363LF0000X, 363LP0808X
PASP022796363LP0808X
DEL8-0000181363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily