Provider Demographics
NPI:1770026817
Name:THOMAS, LYNN ANN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:ANN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 ANN ST APT 1
Mailing Address - Street 2:
Mailing Address - City:ELLENVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12428-2202
Mailing Address - Country:US
Mailing Address - Phone:845-309-8508
Mailing Address - Fax:
Practice Address - Street 1:8 ANN ST APT 1
Practice Address - Street 2:
Practice Address - City:ELLENVILLE
Practice Address - State:NY
Practice Address - Zip Code:12428-2202
Practice Address - Country:US
Practice Address - Phone:845-309-8508
Practice Address - Fax:845-210-7386
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225250-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse