Provider Demographics
NPI:1417356437
Name:CHRISTINA P LYNN, MD
Entity Type:Organization
Organization Name:CHRISTINA P LYNN, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:PITTS
Authorized Official - Last Name:LYNN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-839-6122
Mailing Address - Street 1:1229 38TH AVE N # 411
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29577-1313
Mailing Address - Country:US
Mailing Address - Phone:843-839-6122
Mailing Address - Fax:
Practice Address - Street 1:1418 COLLEGE DR
Practice Address - Street 2:
Practice Address - City:MT CARMEL
Practice Address - State:IL
Practice Address - Zip Code:62863
Practice Address - Country:US
Practice Address - Phone:843-839-6122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-14
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC35441261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA68906OtherMD PSYCHOLOGY
IL036.151498OtherPHYS & SURGEON