Provider Demographics
NPI:1548980303
Name:DEARDURFF, CYNTHIA CHRISTINE
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:CHRISTINE
Last Name:DEARDURFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:891 COUNTY ROAD 5
Mailing Address - Street 2:
Mailing Address - City:ZANESFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:43360-9744
Mailing Address - Country:US
Mailing Address - Phone:937-407-5256
Mailing Address - Fax:
Practice Address - Street 1:891 COUNTY ROAD 5
Practice Address - Street 2:
Practice Address - City:ZANESFIELD
Practice Address - State:OH
Practice Address - Zip Code:43360-9744
Practice Address - Country:US
Practice Address - Phone:937-407-5256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care