Provider Demographics
NPI:1013559210
Name:NGUYEN, LYNN TON (PNP)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:TON
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 W HARGETT ST APT 702
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-4080
Mailing Address - Country:US
Mailing Address - Phone:408-204-3842
Mailing Address - Fax:
Practice Address - Street 1:4551 NEW BERN AVE STE 160
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1552
Practice Address - Country:US
Practice Address - Phone:919-556-1008
Practice Address - Fax:919-556-6099
Is Sole Proprietor?:No
Enumeration Date:2019-10-09
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26592363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics