Provider Demographics
NPI:1437350782
Name:LAMANNA, LYNNE A (RN, MSN, ACNP, CNRN,)
Entity Type:Individual
Prefix:MS
First Name:LYNNE
Middle Name:A
Last Name:LAMANNA
Suffix:
Gender:F
Credentials:RN, MSN, ACNP, CNRN,
Other - Prefix:MISS
Other - First Name:LYNNE
Other - Middle Name:A
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4340 CORRAL CANYON RD
Mailing Address - Street 2:
Mailing Address - City:BONITA
Mailing Address - State:CA
Mailing Address - Zip Code:91902-3016
Mailing Address - Country:US
Mailing Address - Phone:619-316-6168
Mailing Address - Fax:
Practice Address - Street 1:4340 CORRAL CANYON RD
Practice Address - Street 2:
Practice Address - City:BONITA
Practice Address - State:CA
Practice Address - Zip Code:91902-3016
Practice Address - Country:US
Practice Address - Phone:619-316-6168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN441019363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care