Provider Demographics
NPI:1447992821
Name:ST CLAIR, CYNTHIA (FNP-C, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:ST CLAIR
Suffix:
Gender:
Credentials:FNP-C, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16257 PIKES PEAK DR
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80023-8383
Mailing Address - Country:US
Mailing Address - Phone:720-252-9596
Mailing Address - Fax:
Practice Address - Street 1:5377 MANHATTAN CIR STE 204
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-4345
Practice Address - Country:US
Practice Address - Phone:720-465-9272
Practice Address - Fax:303-954-0105
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-07
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0997488363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily