Individual
MRS. CYNTHIA SIDES SHOOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3541 RANDOLPH ROAD, SUITE 206, CHARLOTTE, NC 28211-1253
(704) 381-8336
(704) 381-8332
Mailing address
PO BOX 601372, CHARLOTTE, NC 28260-1372
(704) 381-8336
(704) 381-8332
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
200804
NC
363LF0000X
Family Nurse Practitioner
Primary
51269
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669557138
—
NC
05
—
7005146
—
NC
05
—
NP1292
—
SC
Enumeration date
10/25/2006
Last updated
03/07/2023
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