1912934159 NPI number — MRS. FAYE WELDON LYNCH RN PNP

Table of content: MRS. FAYE WELDON LYNCH RN PNP (NPI 1912934159)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912934159 NPI number — MRS. FAYE WELDON LYNCH RN PNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LYNCH
Provider First Name:
FAYE
Provider Middle Name:
WELDON
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RN PNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912934159
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/05/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1100 CHURCH HILL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MACON
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27551
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
252-257-3780
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
544 W RIDGEWAY ST
Provider Second Line Business Practice Location Address:
WARREN CO HEALTH DEPT
Provider Business Practice Location Address City Name:
WARRENTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27589
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-257-1185
Provider Business Practice Location Address Fax Number:
252-257-4867
Provider Enumeration Date:
06/26/2006

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: 163W00000X , with the licence number:  056930 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0200X , with the licence number: 300310 , 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)