Provider Demographics
NPI:1477633345
Name:CHOW, LYNNE CASEY (MSN FNP)
Entity Type:Individual
Prefix:MS
First Name:LYNNE
Middle Name:CASEY
Last Name:CHOW
Suffix:
Gender:F
Credentials:MSN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 OLCOTT DRIVE
Mailing Address - Street 2:SUITE U3
Mailing Address - City:WHITE RIVER JUNCTION
Mailing Address - State:VT
Mailing Address - Zip Code:05001
Mailing Address - Country:US
Mailing Address - Phone:802-295-6132
Mailing Address - Fax:802-295-1358
Practice Address - Street 1:331 OLCOTT DR
Practice Address - Street 2:SUITE U3
Practice Address - City:WHITE RIVER JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05001-9601
Practice Address - Country:US
Practice Address - Phone:802-295-6132
Practice Address - Fax:802-295-1358
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT1010023800363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30341869Medicaid
VTONP1156Medicaid
VTONP1156Medicaid