1619203429 NPI number — DR. AMY LYNN APRN, DNP, WHNP-BC

Table of content: DR. AMY LYNN APRN, DNP, WHNP-BC (NPI 1619203429)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619203429 NPI number — DR. AMY LYNN APRN, DNP, WHNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LYNN
Provider First Name:
AMY
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
APRN, DNP, WHNP-BC
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:
1619203429
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/08/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1060 W PERIMETER RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JB ANDREWS
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20762-6602
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-404-3573
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
238 BROOKLEY AVE SW BLDG 1300
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BOLLING AFB
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20032-7704
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-404-3573
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/29/2009

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: 163W00000X , with the licence number:  974564 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LW0102X , with the licence number: 14523 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LW0102X , with the licence number: AP143087 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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