Provider Demographics
NPI:1255838561
Name:BYARS, ELLEN (WHNP)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:BYARS
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 NAVAHO DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7443
Mailing Address - Country:US
Mailing Address - Phone:919-401-1000
Mailing Address - Fax:919-401-1037
Practice Address - Street 1:1200 NAVAHO DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7443
Practice Address - Country:US
Practice Address - Phone:919-401-1000
Practice Address - Fax:919-401-1037
Is Sole Proprietor?:No
Enumeration Date:2018-04-12
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5010454363LW0102X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health