Provider Demographics
NPI:1528215407
Name:HONEYCUTT, CYNTHIA KUPSICK (ANP-BC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:KUPSICK
Last Name:HONEYCUTT
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:KUPSICK
Other - Last Name:NORTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP-BC
Mailing Address - Street 1:1420G US HIGHWAY 52 N
Mailing Address - Street 2:
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28001-2622
Mailing Address - Country:US
Mailing Address - Phone:704-982-0161
Mailing Address - Fax:704-512-4838
Practice Address - Street 1:105 YADKIN ST
Practice Address - Street 2:SUITE 203
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-3449
Practice Address - Country:US
Practice Address - Phone:704-982-0161
Practice Address - Fax:704-512-4808
Is Sole Proprietor?:No
Enumeration Date:2008-08-22
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5004069364SA2200X
NC152864363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNC8170COtherMEDICARE INDIVIDUAL PROVIDER NUMBER
NC7005393Medicaid
SCNP3299Medicaid
NC1528215407Medicaid
NCNC8170DMedicare PIN
NC1528215407Medicaid