Provider Demographics
NPI:1790562288
Name:LE, LYNN (PA-C)
Entity Type:Individual
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First Name:LYNN
Middle Name:
Last Name:LE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:13043 ODELL HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:MINT HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28227-4388
Mailing Address - Country:US
Mailing Address - Phone:704-804-8313
Mailing Address - Fax:
Practice Address - Street 1:653 BLUEFIELD RD
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-9599
Practice Address - Country:US
Practice Address - Phone:704-360-6500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant