Provider Demographics
NPI:1851591671
Name:RAOOFI, LYNN MARIE (RNMSPNI)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:MARIE
Last Name:RAOOFI
Suffix:
Gender:F
Credentials:RNMSPNI
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:
Other - Last Name:BUSZKIEWICZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4521 N ARIZONA RD
Mailing Address - Street 2:
Mailing Address - City:APACHE JUNCTION
Mailing Address - State:AZ
Mailing Address - Zip Code:85219
Mailing Address - Country:US
Mailing Address - Phone:480-540-0707
Mailing Address - Fax:602-257-4852
Practice Address - Street 1:1817 NORTH 7TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006
Practice Address - Country:US
Practice Address - Phone:602-257-4845
Practice Address - Fax:602-257-4852
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN048778208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics