Provider Demographics
NPI:1578528006
Name:GRAS, LYNN ELIZABETH (MSN FNP-C)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:ELIZABETH
Last Name:GRAS
Suffix:
Gender:F
Credentials:MSN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11125 TALONCREST WAY UNIT 4
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-6120
Mailing Address - Country:US
Mailing Address - Phone:907-738-3636
Mailing Address - Fax:
Practice Address - Street 1:3380 C ST STE 100
Practice Address - Street 2:EASTERN ALEUTIAN TRIBES, INC
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-3949
Practice Address - Country:US
Practice Address - Phone:907-277-1440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK814363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily