Provider Demographics
NPI:1891375440
Name:LEMON, LYNELL PATTEN
Entity Type:Individual
Prefix:
First Name:LYNELL
Middle Name:PATTEN
Last Name:LEMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7375 INDIAN HILL RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45243-4021
Mailing Address - Country:US
Mailing Address - Phone:619-403-6774
Mailing Address - Fax:
Practice Address - Street 1:7375 INDIAN HILL RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45243-4021
Practice Address - Country:US
Practice Address - Phone:619-403-6774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95037769163W00000X
CA546580163WC1500X
OHRN462363163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95037769OtherBOARD OF NURSING
OH462363OtherNURSING BOARD
CA546580OtherBOARD OF NURSING