Provider Demographics
NPI:1356679708
Name:MCMAHON, LYNETTE ANN (RN)
Entity Type:Individual
Prefix:MRS
First Name:LYNETTE
Middle Name:ANN
Last Name:MCMAHON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 WEST DR
Mailing Address - Street 2:
Mailing Address - City:MENOMINEE
Mailing Address - State:MI
Mailing Address - Zip Code:49858-2327
Mailing Address - Country:US
Mailing Address - Phone:906-863-8216
Mailing Address - Fax:
Practice Address - Street 1:1201 WEST DR
Practice Address - Street 2:
Practice Address - City:MENOMINEE
Practice Address - State:MI
Practice Address - Zip Code:49858-2327
Practice Address - Country:US
Practice Address - Phone:906-863-8216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-23
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI90687-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse