Provider Demographics
NPI:1578384608
Name:DE SOUSA, CYNTHIA (RN)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:DE SOUSA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 HARDING ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-1854
Mailing Address - Country:US
Mailing Address - Phone:508-405-6132
Mailing Address - Fax:
Practice Address - Street 1:53 HARDING ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-1854
Practice Address - Country:US
Practice Address - Phone:508-405-6132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2293921163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine