Basic Information
| Provider Information | |||||||||
| NPI: | 1427193424 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YORK-CAMDEN | ||||||||
| FirstName: | CYNTHIA | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | MS, RD, LDN | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 192 | ||||||||
| Address2: | |||||||||
| City: | DU QUOIN | ||||||||
| State: | IL | ||||||||
| PostalCode: | 628320192 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6185421005 | ||||||||
| FaxNumber: | 6185424756 | ||||||||
| Practice Location | |||||||||
| Address1: | 1032 W INDUSTRIAL PARK RD | ||||||||
| Address2: | |||||||||
| City: | MURPHYSBORO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 629663949 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6189679535 | ||||||||
| FaxNumber: | 6185651701 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/20/2007 | ||||||||
| LastUpdateDate: | 10/28/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | 164003061 | IL | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.