Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 5009494 | NC |
N | 363LA2200X | Nurse Practitioner - Adult Health | 5009494 | NC |
N | 363LW0102X | Nurse Practitioner - Women's Health | 5009494 | NC |
NPI | 1083090666 |
---|---|
Provider Name | Lyssa Rye |
First Address | Durham, NC 27707-5572 |
Second Address | Raleigh, NC 27609 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2015 |
Last Update Date | 20/08/2018 |