Healthcare Provider Details

I. General information

NPI: 1407768799
Provider Name (Legal Business Name): LYNNE AIRHART RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2850 S MAIN ST STE 104
HIGH POINT NC
27263-1900
US

IV. Provider business mailing address

940 WINTERSIDE LN
WINSTON SALEM NC
27107-8764
US

V. Phone/Fax

Practice location:
  • Phone: 336-462-8881
  • Fax: 336-450-1708
Mailing address:
  • Phone: 336-200-7003
  • Fax: 336-450-1708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number566667
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: