Provider Demographics
NPI:1326453531
Name:BORING, LYNNETTA J (ARNP)
Entity Type:Individual
Prefix:
First Name:LYNNETTA
Middle Name:J
Last Name:BORING
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2940 HARRISON AVE
Mailing Address - Street 2:G
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-8017
Mailing Address - Country:US
Mailing Address - Phone:850-276-4592
Mailing Address - Fax:
Practice Address - Street 1:410 W 19TH ST
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-4602
Practice Address - Country:US
Practice Address - Phone:850-522-5490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2014-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9219779363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily