Provider Demographics
NPI:1598765554
Name:HEWITT, LYNNE CATHERINE (NP)
Entity Type:Individual
Prefix:
First Name:LYNNE
Middle Name:CATHERINE
Last Name:HEWITT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 ROUTE 24S BLDG C-3
Mailing Address - Street 2:
Mailing Address - City:COLTS NECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07722
Mailing Address - Country:US
Mailing Address - Phone:732-866-2284
Mailing Address - Fax:
Practice Address - Street 1:201 ROUTE 24S BLDG C-3
Practice Address - Street 2:
Practice Address - City:COLTS NECK
Practice Address - State:NJ
Practice Address - Zip Code:07722
Practice Address - Country:US
Practice Address - Phone:732-866-2284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN0869400363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ9071202Medicaid
NJ9071202Medicaid
NJ074240XVAMedicare UPIN
A03712Medicare UPIN