Provider Demographics
NPI:1225246176
Name:ROUS, LYN LOUISE (FNP)
Entity Type:Individual
Prefix:MISS
First Name:LYN
Middle Name:LOUISE
Last Name:ROUS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1010 SHALIMAR DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93306-5633
Mailing Address - Country:US
Mailing Address - Phone:661-631-6955
Mailing Address - Fax:661-631-6931
Practice Address - Street 1:1010 SHALIMAR DR
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-5633
Practice Address - Country:US
Practice Address - Phone:661-631-6955
Practice Address - Fax:661-631-6931
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANPF10036363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily