1255330726 NPI number — MRS. CHERYL V LYNCH CRNA

Table of content: MRS. CHERYL V LYNCH CRNA (NPI 1255330726)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255330726 NPI number — MRS. CHERYL V LYNCH CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LYNCH
Provider First Name:
CHERYL
Provider Middle Name:
V
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255330726
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/18/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3998 FAIR RIDGE DR
Provider Second Line Business Mailing Address:
SUITE 260
Provider Business Mailing Address City Name:
FAIRFAX
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22033-2907
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-293-9590
Provider Business Mailing Address Fax Number:
702-293-9592

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4320 SEMINARY RD
Provider Second Line Business Practice Location Address:
INOVA ALEXANDRIA HOSPITAL
Provider Business Practice Location Address City Name:
ALEXANDRIA
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22304-1535
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-504-3789
Provider Business Practice Location Address Fax Number:
703-504-3556
Provider Enumeration Date:
07/18/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  RN-0001090656 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207L00000X , with the licence number: CRNA-0024090656 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)