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General NPI Number Information
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NPI Number | 1659577211
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Entity Type | Individual
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Provider Name | LAUREN DENISE LYERLY PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/21/2007
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Last Update Date | 03/18/2020
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Provider Practice Location Address
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Address Line | 1000 BROWN ST
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City | FAITH
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State | NC
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Zip | 28041
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Country | US
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Telephone | 704-216-7060
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Fax | 704-603-8981
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Provider Business Mailing Address
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Address Line | 611 MOCKSVILLE AVE.
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City | SALISBURY
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State | NC
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Zip | 28144-2705
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Country | US
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Telephone | 704-633-7220
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Fax | 704-647-0515
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0010-00936
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-00936
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License Number State | NC
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