Provider Demographics
NPI:1063842813
Name:LYNN, AMBER (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:LYNN
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 W BETHANY HOME RD
Mailing Address - Street 2:SUITE #2
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-1997
Mailing Address - Country:US
Mailing Address - Phone:602-317-2418
Mailing Address - Fax:
Practice Address - Street 1:2200 W BETHANY HOME RD
Practice Address - Street 2:SUITE #2
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-1997
Practice Address - Country:US
Practice Address - Phone:602-710-1187
Practice Address - Fax:602-358-8551
Is Sole Proprietor?:No
Enumeration Date:2013-11-14
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP5269363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health