Provider Demographics
NPI:1619238268
Name:BEVAN, CYNTHIA A (FNP-BC)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:A
Last Name:BEVAN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 HADLEY RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45113-9359
Mailing Address - Country:US
Mailing Address - Phone:937-302-6796
Mailing Address - Fax:
Practice Address - Street 1:1175 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:OH
Practice Address - Zip Code:45177-8904
Practice Address - Country:US
Practice Address - Phone:513-964-0830
Practice Address - Fax:855-461-7823
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.13345363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily