Provider Demographics
NPI:1063017416
Name:LYNN, SHAWN THOMAS
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:THOMAS
Last Name:LYNN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 TOWN CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18040-8368
Mailing Address - Country:US
Mailing Address - Phone:610-250-3651
Mailing Address - Fax:
Practice Address - Street 1:215 TOWN CENTER BLVD
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18040-8368
Practice Address - Country:US
Practice Address - Phone:610-250-3651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP442909183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist