Provider Demographics
NPI:1750685442
Name:GARNER, LYNN M (PA)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:M
Last Name:GARNER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:8203 S SAGINAW ST
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-2434
Mailing Address - Country:US
Mailing Address - Phone:810-953-3600
Mailing Address - Fax:810-953-9543
Practice Address - Street 1:8203 S SAGINAW ST
Practice Address - Street 2:SUITE A
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-2434
Practice Address - Country:US
Practice Address - Phone:810-953-3600
Practice Address - Fax:810-953-9543
Is Sole Proprietor?:No
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5601005619363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5601005619OtherLICENSE