Provider Demographics
NPI:1508208117
Name:MORELAND, LYNN CATHERINE (CFNP)
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:CATHERINE
Last Name:MORELAND
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3952 TEAYS VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-8728
Mailing Address - Country:US
Mailing Address - Phone:304-757-6736
Mailing Address - Fax:304-757-0582
Practice Address - Street 1:3952 TEAYS VALLEY RD
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-8728
Practice Address - Country:US
Practice Address - Phone:304-757-6736
Practice Address - Fax:304-757-0582
Is Sole Proprietor?:No
Enumeration Date:2013-07-24
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVWV 54772363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
P56361Medicare UPIN