Healthcare Provider Details

I. General information

NPI: 1750713657
Provider Name (Legal Business Name): CYNTHIA DIANA SCHUMPERT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2013
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 MEDICAL CENTER DR
HARDEEVILLE SC
29927-3446
US

IV. Provider business mailing address

PO BOX 604411
CHARLOTTE NC
28260-4411
US

V. Phone/Fax

Practice location:
  • Phone: 843-689-8149
  • Fax: 843-689-8431
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number076924-23
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number167075
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number18423
License Number StateSC
# 4
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number18423
License Number StateSC
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5006369
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: