Provider Demographics
NPI:1346330255
Name:GILBERT, LYNN HOWE (RN, PNP-C, PHD)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:HOWE
Last Name:GILBERT
Suffix:
Gender:F
Credentials:RN, PNP-C, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2144 17TH ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-4359
Mailing Address - Country:US
Mailing Address - Phone:303-442-7284
Mailing Address - Fax:
Practice Address - Street 1:3447 W 64TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80221-2163
Practice Address - Country:US
Practice Address - Phone:303-428-4384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO61095363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07610959Medicaid