Provider Demographics
NPI:1275901266
Name:SWEENEY, LYNN SCHRADER (MD)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:SCHRADER
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 KERNEY DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-3660
Mailing Address - Country:US
Mailing Address - Phone:505-860-5620
Mailing Address - Fax:
Practice Address - Street 1:701 KERNEY DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-3660
Practice Address - Country:US
Practice Address - Phone:505-860-5620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-08
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARN-7571208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice