Individual
JONATHAN DOUGLAS LYDAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGPCNP
Contact information
Practice address
189 SAMARITANS RIDGE RD, ELKIN, NC 28621-2472
(336) 526-3005
(336) 526-3011
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(336) 526-3005
(336) 526-3011
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5009435
NC
363L00000X
Nurse Practitioner
RN224686
GA
363LA2200X
Adult Health Nurse Practitioner
5009435
NC
Other
Enumeration date
08/30/2016
Last updated
08/07/2024
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