1639514581 NPI number — MRS. LYNN HAMPTON CLAYTON RDN, LDN, CDCES

Table of content: MRS. LYNN HAMPTON CLAYTON RDN, LDN, CDCES (NPI 1639514581)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639514581 NPI number — MRS. LYNN HAMPTON CLAYTON RDN, LDN, CDCES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CLAYTON
Provider First Name:
LYNN
Provider Middle Name:
HAMPTON
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RDN, LDN, CDCES
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HAMPTON
Provider Other First Name:
DEBORAH
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
RDH
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1639514581
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/14/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2088 CC CAMP RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELKIN
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28621-8371
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
336-355-5756
Provider Business Mailing Address Fax Number:
844-335-7607

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2113 CC CAMP RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELKIN
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28621-8372
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-355-5756
Provider Business Practice Location Address Fax Number:
844-335-7607
Provider Enumeration Date:
05/06/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 133V00000X , with the licence number:  L003309 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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