Provider Demographics
NPI:1225459837
Name:LYNUM, ALLISON (LM)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:LYNUM
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 NW 13TH ST APT 106
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-2141
Mailing Address - Country:US
Mailing Address - Phone:561-900-6127
Mailing Address - Fax:
Practice Address - Street 1:1240 NW 13TH ST APT 106
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-2141
Practice Address - Country:US
Practice Address - Phone:561-900-6127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-27
Last Update Date:2013-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW284176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife