Healthcare Provider Details

I. General information

NPI: 1528215407
Provider Name (Legal Business Name): CYNTHIA KUPSICK HONEYCUTT ANP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CYNTHIA KUPSICK NORTON ANP-BC

II. Dates (important events)

Enumeration Date: 08/22/2008
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3205 RANDALL PKWY STE 105
WILMINGTON NC
28403-2565
US

IV. Provider business mailing address

1420G US HIGHWAY 52 N
ALBEMARLE NC
28001-2622
US

V. Phone/Fax

Practice location:
  • Phone: 910-742-9243
  • Fax: 888-746-1787
Mailing address:
  • Phone: 704-982-0161
  • Fax: 704-512-4838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number5004069
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5004069
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: