Provider Demographics
NPI:1548411879
Name:BRANCH, LYNETTE GALLOWAY (RN, N P/)
Entity Type:Individual
Prefix:MRS
First Name:LYNETTE
Middle Name:GALLOWAY
Last Name:BRANCH
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Gender:F
Credentials:RN, N P/
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Mailing Address - Street 1:5901 HARBOUR HILL PL
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-2123
Mailing Address - Country:US
Mailing Address - Phone:804-739-9148
Mailing Address - Fax:804-232-0272
Practice Address - Street 1:VIRGINIA STATE UNIVERSITY STUDENT HEALTH
Practice Address - Street 2:1 HAYDEN DRIVE
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23806-0001
Practice Address - Country:US
Practice Address - Phone:804-524-5671
Practice Address - Fax:804-524-5026
Is Sole Proprietor?:No
Enumeration Date:2008-10-06
Last Update Date:2009-02-26
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Provider Licenses
StateLicense IDTaxonomies
VA0024053272363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily