Provider Demographics
NPI:1578692794
Name:FIGG, LYNN DAVIS (FNP)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:DAVIS
Last Name:FIGG
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:17405 WILLOWBROOK DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46635-1722
Mailing Address - Country:US
Mailing Address - Phone:574-273-8666
Mailing Address - Fax:574-273-8666
Practice Address - Street 1:611 EAST DOUGLAS ROAD
Practice Address - Street 2:SUITE 405
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-1468
Practice Address - Country:US
Practice Address - Phone:574-335-6240
Practice Address - Fax:574-335-6241
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001301A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201011530Medicaid