Provider Demographics
NPI:1619254570
Name:IACCARINO, LYNN CHRISTINE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:CHRISTINE
Last Name:IACCARINO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9785 JEFFERSON DAVIS HWY
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-9406
Mailing Address - Country:US
Mailing Address - Phone:540-834-1441
Mailing Address - Fax:540-834-1451
Practice Address - Street 1:9785 JEFFERSON DAVIS HWY
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-9406
Practice Address - Country:US
Practice Address - Phone:540-834-1441
Practice Address - Fax:540-834-1451
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-07
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202210868183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist