Provider Demographics
NPI:1316038656
Name:KEEFER-LYNCH, ANN MARIE (NP)
Entity Type:Individual
Prefix:
First Name:ANN MARIE
Middle Name:
Last Name:KEEFER-LYNCH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3615 BANYON RIM RD
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-6916
Mailing Address - Country:US
Mailing Address - Phone:714-693-8400
Mailing Address - Fax:714-744-8630
Practice Address - Street 1:353 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3833
Practice Address - Country:US
Practice Address - Phone:714-771-8000
Practice Address - Fax:714-744-8630
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA357126363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANPF 9809OtherNP FURNISHING # -- FOR WRITING PRESCRIPTIONS