Provider Demographics
NPI:1427708767
Name:ATTAWAY, CYNTHIA MORTON (FNP)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:MORTON
Last Name:ATTAWAY
Suffix:
Gender:F
Credentials:FNP
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 707
Mailing Address - Street 2:
Mailing Address - City:GLEN ALPINE
Mailing Address - State:NC
Mailing Address - Zip Code:28628-0707
Mailing Address - Country:US
Mailing Address - Phone:828-448-8071
Mailing Address - Fax:
Practice Address - Street 1:915 TATE BLVD SE STE 186
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-4042
Practice Address - Country:US
Practice Address - Phone:828-303-2131
Practice Address - Fax:828-320-8348
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-28
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5015981363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1427708767OtherCOMMERCIAL
NC1427708767Medicaid