Healthcare Provider Details

I. General information

NPI: 1992177612
Provider Name (Legal Business Name): LINDSAY NICHOLE NAGUS APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2015
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4225 MACON POND RD STE 200
RALEIGH NC
27607-6385
US

IV. Provider business mailing address

4225 MACON POND RD
RALEIGH NC
27607-6386
US

V. Phone/Fax

Practice location:
  • Phone: 919-791-2040
  • Fax: 919-791-2041
Mailing address:
  • Phone: 919-791-2040
  • Fax: 919-791-2041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5022950
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number209.013200
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: