Provider Demographics
NPI:1689621682
Name:LYNN, JAMES ALAN (CRNA)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ALAN
Last Name:LYNN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 W GRAY ST
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-7117
Mailing Address - Country:US
Mailing Address - Phone:405-364-6182
Mailing Address - Fax:405-364-5379
Practice Address - Street 1:415 W GRAY ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-7117
Practice Address - Country:US
Practice Address - Phone:405-364-6182
Practice Address - Fax:405-364-5379
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK46980367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered