Healthcare Provider Details

I. General information

NPI: 1225107048
Provider Name (Legal Business Name): MARQUITA PLESHETTE LYONS CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 08/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1708 TRAWICK RD SUITE 111
RALEIGH NC
27604-3897
US

IV. Provider business mailing address

118 STATION DR
MORRISVILLE NC
27560-9247
US

V. Phone/Fax

Practice location:
  • Phone: 919-250-3478
  • Fax: 919-250-6272
Mailing address:
  • Phone: 919-402-7216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number0050-01540
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: