Provider Demographics
NPI:1740599612
Name:HELLAMS, LYNETTE ELIZABETH (LPN II)
Entity Type:Individual
Prefix:MS
First Name:LYNETTE
Middle Name:ELIZABETH
Last Name:HELLAMS
Suffix:
Gender:F
Credentials:LPN II
Other - Prefix:MS
Other - First Name:LYNETTE
Other - Middle Name:ELIZABETH
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:225 PINEFIELD DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-3515
Mailing Address - Country:US
Mailing Address - Phone:864-243-8962
Mailing Address - Fax:
Practice Address - Street 1:225 PINEFIELD DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-3515
Practice Address - Country:US
Practice Address - Phone:864-243-8962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCPR 29856164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse