Provider Demographics
NPI:1073614426
Name:WOLD, LYNNE MCELROY (CFNP)
Entity Type:Individual
Prefix:
First Name:LYNNE
Middle Name:MCELROY
Last Name:WOLD
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:LYNNE
Other - Last Name:MCELROY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CFNP
Mailing Address - Street 1:PO BOX 9007
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22906-9007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2014 GOOSE CREEK RD STE 116
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:VA
Practice Address - Zip Code:22980-6588
Practice Address - Country:US
Practice Address - Phone:540-949-6934
Practice Address - Fax:540-943-5540
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA024107160207N00000X
VA0024107160363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P58000Medicare UPIN
VA007084593Medicare ID - Type Unspecified