Provider Demographics
NPI:1114409570
Name:LYNN, TABITHA
Entity Type:Individual
Prefix:MRS
First Name:TABITHA
Middle Name:
Last Name:LYNN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 RIVERBEND WAY
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91914-2026
Mailing Address - Country:US
Mailing Address - Phone:619-370-3248
Mailing Address - Fax:
Practice Address - Street 1:507 RIVERBEND WAY
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91914-2026
Practice Address - Country:US
Practice Address - Phone:619-370-3248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-02
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula