Provider Demographics
NPI:1568454908
Name:ELLINGTON, LYNN NOEL (MD)
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:NOEL
Last Name:ELLINGTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:LYNN
Other - Middle Name:NOEL
Other - Last Name:LAMEIER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4323 CAROTHERS PKWY
Mailing Address - Street 2:STE 208
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-5914
Mailing Address - Country:US
Mailing Address - Phone:615-778-0010
Mailing Address - Fax:615-778-0715
Practice Address - Street 1:4323 CAROTHERS PKWY
Practice Address - Street 2:STE 208
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-5914
Practice Address - Country:US
Practice Address - Phone:615-778-0010
Practice Address - Fax:615-778-0715
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-22
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD 027691207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3099932Medicaid
TN3099932Medicaid
B25700Medicare UPIN