Provider Demographics
NPI:1528025111
Name:MAIDEN, LYNN CAGLE (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:CAGLE
Last Name:MAIDEN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MRS
Other - First Name:SHARON
Other - Middle Name:LYNN
Other - Last Name:MAIDEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNP
Mailing Address - Street 1:9050 EAGLE VALLEY LN
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-6993
Mailing Address - Country:US
Mailing Address - Phone:205-988-9577
Mailing Address - Fax:
Practice Address - Street 1:9050 EAGLE VALLEY LN
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-6993
Practice Address - Country:US
Practice Address - Phone:205-988-9577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-036797363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-32529OtherBCBS WELLSPOT -RIVER
AL515-32530OtherBCBS- SUMMIT WELLSPOT
AL515-32529OtherBCBS WELLSPOT -RIVER
ALS88815Medicare UPIN