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General NPI Number Information
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NPI Number | 1831662048
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Entity Type | Individual
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Provider Name | CYRIL ABA FORCHA FNP
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Gender | Male
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Dates
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Enumeration Date | 01/10/2019
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Last Update Date | 04/21/2022
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Provider Practice Location Address
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Address Line | 101 E WOOD ST
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City | SPARTANBURG
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State | SC
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Zip | 29303-3040
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Country | US
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Telephone | 864-560-6654
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 LYNN MARIE WAY APT#1437
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City | SPARTANBURG
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State | SC
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Zip | 29301
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Country | US
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Telephone | 336-259-0023
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 22495
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5015851
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 22495
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License Number State | SC
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