Healthcare Provider Details

I. General information

NPI: 1568642627
Provider Name (Legal Business Name): CYNTHIA LEIGH UTTER MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2007
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 CAROLINA BAY DRIVE SUITE 200
WILMINGTON NC
28403
US

IV. Provider business mailing address

510 CAROLINA BAY DRIVE SUITE 200
WILMINGTON NC
28403
US

V. Phone/Fax

Practice location:
  • Phone: 910-662-8952
  • Fax: 910-777-5031
Mailing address:
  • Phone: 910-662-8952
  • Fax: 910-777-5031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5022180
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number5022180
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: