Provider Demographics
NPI:1568538205
Name:MCNALLY, LYNN S (NP)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:S
Last Name:MCNALLY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:SUZANNE
Other - Last Name:SCHUSTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:4041 S MCCLINTOCK DR STE 302
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-5879
Mailing Address - Country:US
Mailing Address - Phone:480-339-1780
Mailing Address - Fax:602-357-4604
Practice Address - Street 1:4041 S MCCLINTOCK DR STE 302
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-5879
Practice Address - Country:US
Practice Address - Phone:480-339-1780
Practice Address - Fax:602-357-4604
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP2442363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ118636Medicare PIN
AZZ149419Medicare PIN