Provider Demographics
NPI:1417437419
Name:GOVATOS, LYNNE RAE
Entity Type:Individual
Prefix:
First Name:LYNNE
Middle Name:RAE
Last Name:GOVATOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 COUNTRY HILLS DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-2511
Mailing Address - Country:US
Mailing Address - Phone:302-981-6403
Mailing Address - Fax:
Practice Address - Street 1:17 COUNTRY HILLS DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-2511
Practice Address - Country:US
Practice Address - Phone:302-981-6403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-19
Last Update Date:2018-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE12794374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula