Provider Demographics
NPI:1679570428
Name:CRAMMOND, LYNN AHNELL (RPH)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:AHNELL
Last Name:CRAMMOND
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 PARIS DR
Mailing Address - Street 2:
Mailing Address - City:GODFREY
Mailing Address - State:IL
Mailing Address - Zip Code:62035-1667
Mailing Address - Country:US
Mailing Address - Phone:618-466-5558
Mailing Address - Fax:618-466-9670
Practice Address - Street 1:221 S STATE ST
Practice Address - Street 2:
Practice Address - City:JERSEYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62052-1851
Practice Address - Country:US
Practice Address - Phone:618-498-2323
Practice Address - Fax:618-639-5814
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist