Provider Demographics
NPI:1447648860
Name:SEBRING, CYNTHIA AGNETA
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:AGNETA
Last Name:SEBRING
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:CYNTHIA
Other - Middle Name:AGNETA
Other - Last Name:SEBRING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3879 E BANCROFT CT
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-8294
Mailing Address - Country:US
Mailing Address - Phone:704-430-0409
Mailing Address - Fax:
Practice Address - Street 1:1111 E MCDOWELL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2612
Practice Address - Country:US
Practice Address - Phone:602-839-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-07
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAD177116367500000X
AZ145592367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty