Provider Demographics
NPI:1568734895
Name:PRANGE, LYNDSEY NICOLE (CPNP)
Entity Type:Individual
Prefix:
First Name:LYNDSEY
Middle Name:NICOLE
Last Name:PRANGE
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 ERWIN RD
Mailing Address - Street 2:BOX 3936
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-4699
Mailing Address - Country:US
Mailing Address - Phone:919-668-0477
Mailing Address - Fax:919-681-8943
Practice Address - Street 1:2301 ERWIN RD
Practice Address - Street 2:BOX 3936
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4699
Practice Address - Country:US
Practice Address - Phone:919-668-0477
Practice Address - Fax:919-681-8943
Is Sole Proprietor?:No
Enumeration Date:2012-02-02
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC248051363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics