Provider Demographics
NPI:1821654260
Name:LYNCH, GENEVIEVE KATHLEEN (GENEVIEVE)
Entity Type:Individual
Prefix:
First Name:GENEVIEVE
Middle Name:KATHLEEN
Last Name:LYNCH
Suffix:
Gender:F
Credentials:GENEVIEVE
Other - Prefix:
Other - First Name:GENEVIEVE
Other - Middle Name:KATHLEEN
Other - Last Name:DARWICHE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3801 NW 166TH ST STE 4
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-9279
Mailing Address - Country:US
Mailing Address - Phone:405-359-1122
Mailing Address - Fax:405-359-1100
Practice Address - Street 1:3801 NW 166TH ST STE 4
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73012-9279
Practice Address - Country:US
Practice Address - Phone:405-359-1122
Practice Address - Fax:405-359-1100
Is Sole Proprietor?:No
Enumeration Date:2019-05-10
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK79344163WG0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice