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General NPI Number Information
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NPI Number | 1134639867
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Entity Type | Individual
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Provider Name | JEANNE MARIE LYTHGOE NP-C
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Gender | Female
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Dates
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Enumeration Date | 10/09/2017
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Last Update Date | 08/16/2025
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Provider Practice Location Address
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Address Line | 2153 VALLEYGATE DR STE 101
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-3667
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Country | US
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Telephone | 910-672-0350
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Fax | 910-672-0355
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Provider Business Mailing Address
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Address Line | 129 TUXFORD CT
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City | RAEFORD
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State | NC
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Zip | 28376-6798
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Country | US
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Telephone | 910-670-2010
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Fax | 910-565-2218
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5009890
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License Number State | NC
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