Provider Demographics
NPI:1235192899
Name:GERLACH, LYNN ANN (CRNP)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:ANN
Last Name:GERLACH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:ANN
Other - Last Name:TRICOLLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:409 S 2ND ST
Mailing Address - Street 2:SUITE 2F
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1612
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1824 GOOD HOPE RD
Practice Address - Street 2:
Practice Address - City:ENOLA
Practice Address - State:PA
Practice Address - Zip Code:17025-1233
Practice Address - Country:US
Practice Address - Phone:717-732-8877
Practice Address - Fax:717-732-9241
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP005004B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103037553Medicaid
PA022606Medicare PIN