Doctor Name: | MRS. CYNTHIA OBRIEN DAKIN |
NPI Number: | 1548256761 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MN FNPC |
License Number: | APN 791 |
Business Practice Address: | 4500 Stewart St. Moncrief Army Community Hospital Tmc Fort Jackson, SC - 292075720 |
Business Phone Number: | 8037516475 |
Business Fax Number: | 8037515242 |
Mailing Address: | Moncrief Army Community Hospital, 4500 Stewart St Fort Jackson APO |
State: | AA |
Postal Code: | 292075720 |
Phone Number: | 8037516475 |
Fax Number: | 8037515242 |
NPI Enumeration Date: | 09/22/2005 |
NPI Last Update Date: | 05/10/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | 07/17/2007 |
NPI Reactivation Date: | 08/06/2007 |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | APN 791 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |