Provider Demographics
NPI:1689754210
Name:SPILMAN, LYNN J (NP)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:J
Last Name:SPILMAN
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 1:1 CLARA BARTON DR
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3401
Mailing Address - Country:US
Mailing Address - Phone:518-262-5588
Mailing Address - Fax:518-262-5589
Practice Address - Street 1:1 CLARA BARTON DR
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3401
Practice Address - Country:US
Practice Address - Phone:518-262-5588
Practice Address - Fax:518-262-5589
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY350191363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner