Provider Demographics
NPI:1659376549
Name:DOULIN, LYNDA KAREN (CRNP)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:KAREN
Last Name:DOULIN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:LYNDA KAREN
Other - Middle Name:SEYMOUR
Other - Last Name:DOULIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNP
Mailing Address - Street 1:PO BOX 609
Mailing Address - Street 2:
Mailing Address - City:ANDALUSIA
Mailing Address - State:AL
Mailing Address - Zip Code:36420-1211
Mailing Address - Country:US
Mailing Address - Phone:334-222-0184
Mailing Address - Fax:334-222-0625
Practice Address - Street 1:601 W BYPASS
Practice Address - Street 2:
Practice Address - City:ANDALUSIA
Practice Address - State:AL
Practice Address - Zip Code:36420-4732
Practice Address - Country:US
Practice Address - Phone:334-222-0184
Practice Address - Fax:334-222-0625
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2023-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-061198363LP0200X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000020702Medicaid
AL000020702Medicare ID - Type Unspecified
AL000020702Medicaid