Provider Demographics
NPI:1013208073
Name:HART, LYNN M (RN)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:M
Last Name:HART
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 CANARAS AVE
Mailing Address - Street 2:
Mailing Address - City:SARANAC LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12983-1560
Mailing Address - Country:US
Mailing Address - Phone:518-891-1663
Mailing Address - Fax:518-891-6615
Practice Address - Street 1:141 PETROVA AVE
Practice Address - Street 2:
Practice Address - City:SARANAC LAKE
Practice Address - State:NY
Practice Address - Zip Code:12983-1560
Practice Address - Country:US
Practice Address - Phone:518-897-1663
Practice Address - Fax:518-891-6615
Is Sole Proprietor?:No
Enumeration Date:2011-04-26
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY266112163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool