Provider Demographics
NPI:1558161513
Name:HANCOCK, CYNTHIA CHAPMAN
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:CHAPMAN
Last Name:HANCOCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:657 E 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-1027
Mailing Address - Country:US
Mailing Address - Phone:980-522-1655
Mailing Address - Fax:
Practice Address - Street 1:657 E 12TH AVE
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-1027
Practice Address - Country:US
Practice Address - Phone:980-522-1655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-18
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC30375363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner