Provider Demographics
NPI:1760865612
Name:BROPHY, LYNNE LAURENCE (RN-BC, MSN, AOCN)
Entity Type:Individual
Prefix:MS
First Name:LYNNE
Middle Name:LAURENCE
Last Name:BROPHY
Suffix:
Gender:F
Credentials:RN-BC, MSN, AOCN
Other - Prefix:MS
Other - First Name:LYNNE
Other - Middle Name:LAURENCE
Other - Last Name:RUSSELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:460 W 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43210-1240
Mailing Address - Country:US
Mailing Address - Phone:614-366-3733
Mailing Address - Fax:
Practice Address - Street 1:460 W 10TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1240
Practice Address - Country:US
Practice Address - Phone:614-366-3733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-09
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN2776831163WX0200X
OHCOA08030-NS163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0200XNursing Service ProvidersRegistered NurseOncology