Provider Demographics
NPI:1760400600
Name:STYSLINGER, LYNN MARIE (MS, RD, LDN)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:MARIE
Last Name:STYSLINGER
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:
Other - Last Name:CARLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:512 E DAVIE ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27601-1918
Mailing Address - Country:US
Mailing Address - Phone:919-832-2400
Mailing Address - Fax:919-832-5151
Practice Address - Street 1:512 E DAVIE ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27601-1918
Practice Address - Country:US
Practice Address - Phone:919-832-2400
Practice Address - Fax:919-832-5151
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL001075133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2994622Medicare PIN