Provider Demographics
NPI:1942077003
Name:LYNCH, SHONNON R
Entity Type:Individual
Prefix:MS
First Name:SHONNON
Middle Name:R
Last Name:LYNCH
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 1:3064 ZEBULON RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-2423
Mailing Address - Country:US
Mailing Address - Phone:252-885-8818
Mailing Address - Fax:
Practice Address - Street 1:3064 ZEBULON RD
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-2423
Practice Address - Country:US
Practice Address - Phone:252-885-8818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-08
Last Update Date:2024-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory