Healthcare Provider Details

I. General information

NPI: 1649287087
Provider Name (Legal Business Name): CYNTHIA LYNN PAGE APRN-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 02/06/2026
Certification Date: 02/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3793 MCDOWELL LN
LITTLE RIVER SC
29566-7892
US

IV. Provider business mailing address

3793 MCDOWELL LN
LITTLE RIVER SC
29566-7892
US

V. Phone/Fax

Practice location:
  • Phone: 843-390-0877
  • Fax:
Mailing address:
  • Phone: 843-390-0877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number2998
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: