Provider Demographics
NPI:1538504527
Name:LEVER, LYNNETTE
Entity Type:Individual
Prefix:
First Name:LYNNETTE
Middle Name:
Last Name:LEVER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 718
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:SC
Mailing Address - Zip Code:29108-0718
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7288 US HIGHWAY 176
Practice Address - Street 2:
Practice Address - City:POMARIA
Practice Address - State:SC
Practice Address - Zip Code:29126-9423
Practice Address - Country:US
Practice Address - Phone:803-321-2651
Practice Address - Fax:803-321-2652
Is Sole Proprietor?:No
Enumeration Date:2013-05-03
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC54144163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse