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Individual

LYNNESSA ROBYN WIDELO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
280 N POINTE BLVD STE 3, MOUNT AIRY, NC 27030-2267
(336) 948-9333
Mailing address
2282 REED CREEK DR, DRAPER, VA 24324-2858

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
0024182343
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5017817
NC

Other

Enumeration date
08/17/2021
Last updated
11/18/2024
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