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General NPI Number Information
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NPI Number | 1184611139
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Entity Type | Individual
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Provider Name | ELLA OLEHONNA LYNCH FNP-C, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/04/2005
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 773 OLD MAIN RD
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City | PEMBROKE
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State | NC
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Zip | 28372-8753
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Country | US
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Telephone | 910-775-9201
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Fax | 910-521-8540
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Provider Business Mailing Address
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Address Line | PO BOX 3605
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City | PEMBROKE
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State | NC
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Zip | 28372-3605
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Country | US
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Telephone | 910-740-3508
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Fax | 910-521-8540
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0050-00705
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 5000705
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License Number State | NC
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