Provider Demographics
NPI:1891920740
Name:LYNCH, VIRGINIA KATHLEEN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:KATHLEEN
Last Name:LYNCH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:VIRGINIA
Other - Middle Name:KATHLEEN
Other - Last Name:CHANDLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:4715 WHITESBURG DR SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-1632
Mailing Address - Country:US
Mailing Address - Phone:256-881-5151
Mailing Address - Fax:256-539-1252
Practice Address - Street 1:4715 WHITESBURG DR SE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-1632
Practice Address - Country:US
Practice Address - Phone:256-881-5151
Practice Address - Fax:256-881-3939
Is Sole Proprietor?:No
Enumeration Date:2009-05-21
Last Update Date:2017-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPA-C600363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant