Individual provider Active NPI

Heather Lynn Cynowa, PMHNP-BC, FNP-BC

  • Nurse Practitioner
  • Fayetteville, NC
National Provider Identifier
1114451754
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5009667 Issued in NC
Practice address
304 Barcelona Dr Apt 13a
Fayetteville, NC 28303-5752
Phone
(984) 304-8330
Fax
(984) 305-8331
NPI assigned
Apr 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5009667 NC Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2024027949 NC
Family Nurse Practitioner 363LF0000X 2017002067 NC

Addresses

Primary practice location

304 Barcelona Dr Apt 13a
Fayetteville, NC 28303-5752

Mailing address

1023 Fairfield Cir
Raeford, NC 28376-6607
Phone (910) 550-3803

Other practice location 1

2817 Reilly St
Byars Health Clinic
Fort Bragg, NC 28310-7324
Phone (910) 907-7673

Other practice location 2

204 Westwood Shopping Ctr
Fayetteville, NC 28314-1528
Phone (910) 676-7570

Other practice location 3

2000 Fort Bragg Rd Ste 4
Fayetteville, NC 28303-7041
Phone (984) 304-8330

Other practice location 4

517 Deerpath Dr
Fayetteville, NC 28311-1231
Phone (910) 574-3297

Other practice location 5

2000 Fort Bragg Rd Ste 4
Fayetteville, NC 28303-7041
Phone (910) 574-3297

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180205001665 NC Practitioner - Nurse Practitioner 4284994633 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5009667NCMDNurse Practitioner
2017002067NCMDFamily Nurse Practitioner
2024027949NCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
KV Consultants & Associates Inc CurrentSince Jul 17, 2024 Accepting new patients
Break the Stigma, PLLC Family CurrentSince Sep 28, 2025 Accepting new patients
Hodges Family Pharmacy LLC PastSince Jan 3, 2018 Accepting new patients
Kindred Spirit Counseling Services PLLC Psychiatric/Mental Health PastSince Dec 22, 2024 Accepting new patients

Locations

803 Stamper Rd
Ste G
Fayetteville, NC 28303
Phone (910) 223-7114

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1492560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1114451754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 FAIRFIELD CIR",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283766607",
            "telephone_number": "910-550-3803",
            "fax_number": "910-550-3803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 BARCELONA DR APT 13A",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035752",
            "telephone_number": "984-304-8330",
            "fax_number": "984-305-8331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2817 Reilly St",
            "address_2": "Byars Health Clinic",
            "address_purpose": "LOCATION",
            "city": "Fort Bragg",
            "state": "NC",
            "postal_code": "283107324",
            "country_code": "US",
            "telephone_number": "910-907-7673",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "204 Westwood Shopping Ctr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283141528",
            "country_code": "US",
            "telephone_number": "910-676-7570",
            "fax_number": "910-676-7572",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2000 Fort Bragg Rd Ste 4",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283037041",
            "country_code": "US",
            "telephone_number": "984-304-8330",
            "fax_number": "984-304-8331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "517 Deerpath Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283111231",
            "country_code": "US",
            "telephone_number": "910-574-3297",
            "fax_number": "888-649-2671",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2000 Fort Bragg Rd Ste 4",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283037041",
            "country_code": "US",
            "telephone_number": "910-574-3297",
            "fax_number": "888-649-2671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CYNOWA",
        "first_name": "HEATHER",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-19",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5009667",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "2024027949",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "2017002067",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.