Provider Demographics
NPI:1831126184
Name:CHARRLIN, LYNN L (MD)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:L
Last Name:CHARRLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 S MUCKEY ST
Mailing Address - Street 2:
Mailing Address - City:MAPLETON
Mailing Address - State:IA
Mailing Address - Zip Code:51034-1055
Mailing Address - Country:US
Mailing Address - Phone:712-882-2234
Mailing Address - Fax:712-423-9402
Practice Address - Street 1:513 S MUCKEY ST
Practice Address - Street 2:
Practice Address - City:MAPLETON
Practice Address - State:IA
Practice Address - Zip Code:51034-1055
Practice Address - Country:US
Practice Address - Phone:712-882-2234
Practice Address - Fax:712-423-9402
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002011470207Q00000X
IAMD-42176207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO010568509Medicaid
MO208369009Medicaid
33098051OtherBCBS
MO540568508Medicaid
33098031OtherBCBS
33098041OtherBCBS
DA4239Medicare PIN
33098041OtherBCBS
MO010568509Medicaid
261320Medicare PIN
33098051OtherBCBS
33098031OtherBCBS