Provider Demographics
NPI:1669773404
Name:LYNN, CAROLINE KAYE (NP-C)
Entity type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:KAYE
Last Name:LYNN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:720 MALCOLM BLVD
Mailing Address - Street 2:
Mailing Address - City:VALDESE
Mailing Address - State:NC
Mailing Address - Zip Code:28690-2872
Mailing Address - Country:US
Mailing Address - Phone:828-580-7536
Mailing Address - Fax:828-580-7537
Practice Address - Street 1:720 MALCOLM BLVD
Practice Address - Street 2:
Practice Address - City:VALDESE
Practice Address - State:NC
Practice Address - Zip Code:28690-2872
Practice Address - Country:US
Practice Address - Phone:828-580-7536
Practice Address - Fax:828-580-7537
Is Sole Proprietor?:No
Enumeration Date:2010-11-10
Last Update Date:2020-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC191652363LA2200X
NC5004695363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health