Provider Demographics
NPI:1710972823
Name:RANKIN, LYNN (MD)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:RANKIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 PENN AVE
Mailing Address - Street 2:SUITE 411
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50316-2350
Mailing Address - Country:US
Mailing Address - Phone:515-265-1300
Mailing Address - Fax:515-265-2001
Practice Address - Street 1:1301 PENN AVE
Practice Address - Street 2:SUITE 411
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50316-2350
Practice Address - Country:US
Practice Address - Phone:515-265-1300
Practice Address - Fax:515-265-2001
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA287932084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1710972823Medicaid
IAP01294541OtherRR MEDICARE
IA2085704Medicaid
IAP01294541OtherRR MEDICARE
IA1710972823Medicaid
IA719260589Medicare PIN