Provider Demographics
NPI:1083949846
Name:GELLERMAN, LYNN MARY (ARNP)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:MARY
Last Name:GELLERMAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12550 NEW BRITTANY BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-3655
Mailing Address - Country:US
Mailing Address - Phone:239-936-1114
Mailing Address - Fax:239-936-5968
Practice Address - Street 1:12550 NEW BRITTANY BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-3655
Practice Address - Country:US
Practice Address - Phone:239-936-1114
Practice Address - Fax:239-936-5968
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-13
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3376072363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health