Provider Demographics
NPI:1417094046
Name:MCENROE, LYNNE E (RN)
Entity Type:Individual
Prefix:MS
First Name:LYNNE
Middle Name:E
Last Name:MCENROE
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 1:288 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:PORT MURRAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07865-4062
Mailing Address - Country:US
Mailing Address - Phone:908-835-7980
Mailing Address - Fax:908-835-7980
Practice Address - Street 1:65 BERGEN ST
Practice Address - Street 2:SUITE 1142
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07107-3001
Practice Address - Country:US
Practice Address - Phone:973-972-8167
Practice Address - Fax:973-972-3225
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO04545800163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health