Provider Demographics
NPI:1437442332
Name:REICHLE, LYNN L (NP)
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:L
Last Name:REICHLE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:L
Other - Last Name:MOORE SHERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1000 WILLOW CREEK RD.
Mailing Address - Street 2:SUITE B
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301
Mailing Address - Country:US
Mailing Address - Phone:928-778-4371
Mailing Address - Fax:928-771-8447
Practice Address - Street 1:1000 WILLOW CREEK ROAD
Practice Address - Street 2:SUITE B
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301
Practice Address - Country:US
Practice Address - Phone:928-778-4371
Practice Address - Fax:928-771-8447
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9223382363LP2300X
AZAP4106363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care