Individual
ELIZABETH SUSAN LYERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON-SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 602658, CHARLOTTE, NC 28260-2658
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
100757
NC
363AM0700X
Medical Physician Assistant
100757
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
94677
MEDCOST
NC
Enumeration date
05/18/2007
Last updated
09/29/2020
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