Provider Demographics
NPI:1053929075
Name:GARAY, CYNTHIA ELAINE (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ELAINE
Last Name:GARAY
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 VILLAGE CENTER CIR STE 3-717
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134-6299
Mailing Address - Country:US
Mailing Address - Phone:702-432-2233
Mailing Address - Fax:702-800-5456
Practice Address - Street 1:2020 WELLNESS WAY STE 300
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4145
Practice Address - Country:US
Practice Address - Phone:702-432-2233
Practice Address - Fax:702-432-2233
Is Sole Proprietor?:No
Enumeration Date:2020-07-15
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95014858363L00000X
SCAPN.24081363LF0000X
NV840034363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV250014830Medicaid