Provider Demographics
NPI:1336890565
Name:LYNCH, DRIYANNA (BSN, RN)
Entity Type:Individual
Prefix:
First Name:DRIYANNA
Middle Name:
Last Name:LYNCH
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:192 VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-7299
Mailing Address - Country:US
Mailing Address - Phone:910-577-1400
Mailing Address - Fax:
Practice Address - Street 1:192 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-7299
Practice Address - Country:US
Practice Address - Phone:910-577-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FL9552291163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program