Provider Demographics
NPI:1184604159
Name:BARNHARDT, CYNTHIA WHITLEY (NP)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:WHITLEY
Last Name:BARNHARDT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 602344
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2344
Mailing Address - Country:US
Mailing Address - Phone:704-403-3664
Mailing Address - Fax:704-403-3665
Practice Address - Street 1:5370 RIDGE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-0447
Practice Address - Country:US
Practice Address - Phone:704-316-1491
Practice Address - Fax:704-316-1492
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC01914363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2592309COtherMEDICARE
NC7000327Medicaid
NCM2592309Medicare PIN
NCQ34887Medicare UPIN
NC7000327Medicaid