Provider Demographics
NPI:1437580222
Name:GARVEY, LYNNE A (CRNP)
Entity Type:Individual
Prefix:
First Name:LYNNE
Middle Name:A
Last Name:GARVEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:LYNNE
Other - Middle Name:A
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:301 SCIENCE PARK RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-2293
Mailing Address - Country:US
Mailing Address - Phone:814-272-5805
Mailing Address - Fax:814-272-0110
Practice Address - Street 1:301 SCIENCE PARK RD
Practice Address - Street 2:SUITE 207
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803
Practice Address - Country:US
Practice Address - Phone:814-272-5805
Practice Address - Fax:814-272-0110
Is Sole Proprietor?:No
Enumeration Date:2013-12-05
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012227363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
P01412484OtherRAILROAD MEDICARE
PA103067060Medicaid
50128372OtherCAPITAL BC
PA103067060Medicaid
PA328964QV2Medicare PIN