Provider Demographics
NPI:1184611139
Name:LYNCH, ELLA OLEHONNA (FNP-C, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ELLA
Middle Name:OLEHONNA
Last Name:LYNCH
Suffix:
Gender:F
Credentials:FNP-C, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3605
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372-3605
Mailing Address - Country:US
Mailing Address - Phone:910-740-3508
Mailing Address - Fax:910-521-8540
Practice Address - Street 1:773 OLD MAIN RD
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:NC
Practice Address - Zip Code:28372-8753
Practice Address - Country:US
Practice Address - Phone:910-775-9201
Practice Address - Fax:910-521-8540
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0050-00705363LF0000X
NC5000705363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7004349Medicaid
NC5917311Medicaid
ML1289936OtherDEA