Provider Demographics
NPI:1114367299
Name:WHITTAKER, LYNN S (CRNP)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:S
Last Name:WHITTAKER
Suffix:
Gender:F
Credentials:CRNP
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1800 E PARK AVE
Mailing Address - Street 2:LANCE AND ELLEN SHANER CANCER PAVILION
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-6709
Mailing Address - Country:US
Mailing Address - Phone:814-272-4400
Mailing Address - Fax:814-231-7295
Practice Address - Street 1:1800 E PARK AVE
Practice Address - Street 2:LANCE AND ELLEN SHANER CANCER PAVILION
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-6709
Practice Address - Country:US
Practice Address - Phone:814-272-4400
Practice Address - Fax:814-231-7295
Is Sole Proprietor?:No
Enumeration Date:2013-07-03
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASP012934363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily