Provider Demographics
NPI:1861721052
Name:DUMLAO-TAITANO, CYNTHIA NUNEZ (NP)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:NUNEZ
Last Name:DUMLAO-TAITANO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 CHALAN KARETA
Mailing Address - Street 2:
Mailing Address - City:MANGILAO
Mailing Address - State:GU
Mailing Address - Zip Code:96913-6304
Mailing Address - Country:US
Mailing Address - Phone:671-735-7121
Mailing Address - Fax:671-734-7097
Practice Address - Street 1:123 CHALAN KARETA
Practice Address - Street 2:
Practice Address - City:MANGILAO
Practice Address - State:GU
Practice Address - Zip Code:96913-6304
Practice Address - Country:US
Practice Address - Phone:671-735-7121
Practice Address - Fax:671-734-7097
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-16
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUNP0004363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health