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Individual

BRITTANY AUTUMN LYDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3333 SILAS CREEK PKWY, WINSTON SALEM, NC 27103-3013
(336) 718-7224
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
(336) 718-7224
(414) 955-6211

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-11516
NC
363A00000X
Physician Assistant
5157
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1457984908
WI
Enumeration date
02/12/2020
Last updated
07/19/2023
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