Provider Demographics
NPI:1861864324
Name:LLOYD, DELETHIA (AGNP)
Entity Type:Individual
Prefix:
First Name:DELETHIA
Middle Name:
Last Name:LLOYD
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 CROASDAILE FARM PKWY
Mailing Address - Street 2:AMBULATORY CARE CLINIC
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-1331
Mailing Address - Country:US
Mailing Address - Phone:919-384-2571
Mailing Address - Fax:
Practice Address - Street 1:2600 CROASDAILE FARM PKWY
Practice Address - Street 2:AMBULATORY CARE CLINIC
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-1331
Practice Address - Country:US
Practice Address - Phone:919-384-2571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-23
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5008129363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology