Provider Demographics
NPI:1891744074
Name:LYNCH, CHARLOTTE J (RN, MS, CNS)
Entity Type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:J
Last Name:LYNCH
Suffix:
Gender:F
Credentials:RN, MS, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3121 EVELYN DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45434-6382
Mailing Address - Country:US
Mailing Address - Phone:937-320-0755
Mailing Address - Fax:937-320-1589
Practice Address - Street 1:3121 EVELYN DR
Practice Address - Street 2:SUITE 110
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45434-6382
Practice Address - Country:US
Practice Address - Phone:937-320-0755
Practice Address - Fax:937-320-1589
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNS-04365364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHNS-04365OtherBOARD OF NURSING LICENSE