MS. MARY LEE CUDD (NPI# 1730266453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730266453 |
| Entity Type | Individual |
| Full Name | MS. MARY LEE CUDD |
| Credential | PAC |
| Practice Address |
1774 Metromedical Drive Fayetteville NC 28304 |
| Practice Telephone | 9103231203 |
| Practice Fax Number | 9103233101 |
| Mailing Telephone | 9103231203 |
| Mailing Fax Number | 9103233101 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2012-01-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
0100900 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1774 METROMEDICAL DRIVE |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588805188 | Cid Pa | Internal Medicine | 1774 Metromedical Drive, Fayetteville, NC 28304-3861 | 2009-03-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301061 | Coast To Coast Bilingual Counseling | Social Worker | 910 Hope Mills Road, Fayetteville, NC 28304 | 2019-11-20 |
| 1811530561 | Frances L. Hurst | Technician | 6732 Carloway Dr, Fayetteville, NC 28304 | 2019-10-25 |
| 1538717764 | Rose Mary A O'conner | Technician | 3530 Madison Ave, Fayetteville, NC 28304 | 2019-08-30 |
| 1932756087 | Sally Frances Jones | Technician | 2053 Mango Circle, Fayetteville, NC 28304 | 2019-08-23 |
| 1326528803 | Jeneen Yvette Townsend | Counselor | 2671 Adams Lake Dr Apt F, Fayetteville, NC 28304 | 2018-08-15 |
| 1780179580 | Ma Cornelia Villavicencio Leano | Nurse Practitioner | 3081 Stone Carriage Cir Apt Z, Fayetteville, NC 28304 | 2018-06-25 |
| 1861986267 | Pediatric After Hours Care of Fayetteville | Pediatrics | 556 Sandhurst Drive, Fayetteville, NC 28304 | 2018-06-19 |
| 1700386133 | Good Night Medical of Ohio, LLC | Durable Medical Equipment & Medical Supplies | 405 Owen Dr Ste 202, Fayetteville, NC 28304 | 2018-02-12 |
| 1003321365 | Valleygate Dental Surgery Center of Fayetteville, LLC | Dentist | 2038 Litho Place, Fayetteville, NC 28304 | 2017-12-08 |
| 1871004663 | The Salt Project | Marriage & Family Therapist | 1611-b Owen Dr., Fayetteville, NC 28304 | 2017-10-19 |
| Find all providers in zip 28304 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083046635 | Jason David Kranenburg | Physician Assistant | 170 Hayden Ct, Fayetteville, GA 30215-2549 | 2013-08-06 |
| 1831391655 | Mandy Suzanne Mooneyham | Physician Assistant | 3053 N College Ave, Fayetteville, AR 72703-3417 | 2007-06-04 |
| 1043318611 | Dena Marie Pozeg | Physician Assistant | 4140 Ferncreek Drive, Suite 601, Fayetteville, NC 28314-2569 | 2006-09-20 |
| 1407460843 | Alexandra Paige Brown | Physician Assistant | 1695 E Rainforest Rd, Fayetteville, AR 72703-5385 | 2020-09-02 |
| 1134668007 | Gerald Crist | Physician Assistant | 1638 Owen Dr, Fayetteville, NC 28304-3424 | 2017-02-13 |
| 1477941367 | Sarah Busbin | Physician Assistant | 4140 Ferncreek Dr, Suite 801, Fayetteville, NC 28314-2563 | 2014-12-31 |
| 1265820260 | Ashley Ronk | Physician Assistant | 4140 Ferncreek Dr, Suite 801, Fayetteville, NC 28314-2563 | 2014-12-30 |
| 1275894826 | Timothy Richard Key | Physician Assistant | 115 Edenton Estates Dr, Fayetteville, GA 30214-4442 | 2012-05-30 |
| 1932258993 | Alexandra Fischell Fitzgerald | Physician Assistant | 4140 Ferncreek Dr, Suite 801, Fayetteville, NC 28314-2563 | 2007-01-09 |
| 1881767580 | Cynthia Shawn Earl | Physician Assistant | 2300 Ramsey St, Fayetteville, NC 28301-3856 | 2006-11-17 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28304 |
Please comment or provide details below to improve the information on MS. MARY LEE CUDD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.