Provider Demographics
NPI:1497117154
Name:NOBLE, CYNTHIA ERONMWON (PA-C)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ERONMWON
Last Name:NOBLE
Suffix:
Gender:
Credentials:PA-C
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 689022
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37068-9022
Mailing Address - Country:US
Mailing Address - Phone:615-465-7211
Mailing Address - Fax:615-628-6877
Practice Address - Street 1:1727 CHUCKWA DR STE 100
Practice Address - Street 2:
Practice Address - City:DURANT
Practice Address - State:OK
Practice Address - Zip Code:74701-2151
Practice Address - Country:US
Practice Address - Phone:580-931-8848
Practice Address - Fax:580-931-8877
Is Sole Proprietor?:No
Enumeration Date:2016-03-22
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA10371363A00000X
OK5540363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant