Basic Information
| Provider Information | |||||||||
| NPI: | 1528087376 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZEIGLER | ||||||||
| FirstName: | CYNTHIA | ||||||||
| MiddleName: | ROURK | ||||||||
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| Credential: | CFNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 743904 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303743904 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8032967320 | ||||||||
| FaxNumber: | 8032967330 | ||||||||
| Practice Location | |||||||||
| Address1: | 115 N SUMTER ST STE 115 | ||||||||
| Address2: | |||||||||
| City: | SUMTER | ||||||||
| State: | SC | ||||||||
| PostalCode: | 291504968 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8037747546 | ||||||||
| FaxNumber: | 8037749455 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2006 | ||||||||
| LastUpdateDate: | 09/01/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | APRN1303 | SC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 163W00000X | APRN1303 | SC | N | Nursing Service Providers | Registered Nurse |
ID Information
| ID | Type | State | Issuer | Description | 20007233 | 01 | SC | SELECT HLTH | OTHER | 500025199 | 01 | SC | RRMC | OTHER | NP0494 | 05 | SC | MEDICAID |