Provider Demographics
NPI:1437512258
Name:LYNN, ROBIN WOOLLENS (CRNP)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:WOOLLENS
Last Name:LYNN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:W
Other - Last Name:BRUBAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-721-5712
Mailing Address - Fax:717-721-5712
Practice Address - Street 1:175 MARTIN AVE
Practice Address - Street 2:SUITE 125
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-1761
Practice Address - Country:US
Practice Address - Phone:717-721-5700
Practice Address - Fax:717-721-5712
Is Sole Proprietor?:No
Enumeration Date:2016-03-30
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP015970207V00000X, 363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103106140Medicaid