Provider Demographics
NPI:1053754754
Name:LEAVER, CYNTHIA ANN (PHD, RN, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ANN
Last Name:LEAVER
Suffix:
Gender:F
Credentials:PHD, RN, FNP-BC
Other - Prefix:MISS
Other - First Name:CYNTHIA
Other - Middle Name:ANN
Other - Last Name:ANDREWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, MSN, FNP-BC
Mailing Address - Street 1:3916 RIVE DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22309-3031
Mailing Address - Country:US
Mailing Address - Phone:703-969-3661
Mailing Address - Fax:
Practice Address - Street 1:8008 WESTPARK DR
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22102-3109
Practice Address - Country:US
Practice Address - Phone:703-287-6442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-11
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024168593363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily