Provider Demographics
NPI:1528001914
Name:GILBERT, LYNN STYERS (PA-C)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:STYERS
Last Name:GILBERT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:GRAY
Other - Last Name:STYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4601 PARK RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-3239
Mailing Address - Country:US
Mailing Address - Phone:704-323-2000
Mailing Address - Fax:
Practice Address - Street 1:950 STATE FARM RD STE 200
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-5021
Practice Address - Country:US
Practice Address - Phone:704-323-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-04976363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1528001914Medicaid
NC0010-04976OtherNC MEDICAL LICENSE
VA009326V99Medicare PIN
NC0010-04976OtherNC MEDICAL LICENSE
NC1528001914Medicaid