Provider Demographics
NPI:1891402319
Name:NOWLAND, LYNN DYETT (RN)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:DYETT
Last Name:NOWLAND
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 COUGAR ST
Mailing Address - Street 2:
Mailing Address - City:VERNONIA
Mailing Address - State:OR
Mailing Address - Zip Code:97064-1282
Mailing Address - Country:US
Mailing Address - Phone:503-815-7560
Mailing Address - Fax:503-429-1956
Practice Address - Street 1:1005 COUGAR ST
Practice Address - Street 2:
Practice Address - City:VERNONIA
Practice Address - State:OR
Practice Address - Zip Code:97064-1282
Practice Address - Country:US
Practice Address - Phone:503-815-7560
Practice Address - Fax:503-429-1956
Is Sole Proprietor?:No
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201808976RN163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management