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General NPI Number Information
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NPI Number | 1205960937
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Entity Type | Individual
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Provider Name | NICOLE ERICA CYPHERT MS OTR L
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Gender | Female
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 01/17/2010
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Provider Practice Location Address
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Address Line | 5407 CANIPE FARM CT
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City | CHARLOTTE
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State | NC
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Zip | 28269-5029
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Country | US
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Telephone | 704-248-1146
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Fax | 187-726-8534
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Provider Business Mailing Address
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Address Line | PO BOX 34035
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City | CHARLOTTE
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State | NC
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Zip | 28234-4035
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Country | US
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Telephone | 704-248-1146
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Fax | 187-726-8534
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 5804
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License Number State | NC
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