Provider Demographics
NPI:1326498650
Name:LYNCH, EMILY NICOLE (DO)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:NICOLE
Last Name:LYNCH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 JOHN MCGHEE BLVD
Mailing Address - Street 2:
Mailing Address - City:CARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37714-3155
Mailing Address - Country:US
Mailing Address - Phone:865-647-3220
Mailing Address - Fax:423-566-6871
Practice Address - Street 1:140 JOHN MCGHEE BLVD
Practice Address - Street 2:
Practice Address - City:CARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37714-3155
Practice Address - Country:US
Practice Address - Phone:865-647-3220
Practice Address - Fax:423-566-6871
Is Sole Proprietor?:No
Enumeration Date:2016-06-17
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02005295A207Q00000X
IN11018884A390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program