Provider Demographics
NPI:1275733933
Name:DEAN, LYNN DIXON (FNP-C)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:DIXON
Last Name:DEAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:147 REINHARDT COLLEGE PKWY
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-5641
Mailing Address - Country:US
Mailing Address - Phone:770-345-3630
Mailing Address - Fax:770-345-3655
Practice Address - Street 1:147 REINHARDT COLLEGE PKWY
Practice Address - Street 2:SUITE 4
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-5641
Practice Address - Country:US
Practice Address - Phone:770-345-3630
Practice Address - Fax:770-345-3655
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAR080864363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily