Provider Demographics
NPI:1952474876
Name:VARNER, LYNDA LEE (CNM MSN)
Entity Type:Individual
Prefix:MRS
First Name:LYNDA
Middle Name:LEE
Last Name:VARNER
Suffix:
Gender:F
Credentials:CNM MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3016 W WACKERLY ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-6160
Mailing Address - Country:US
Mailing Address - Phone:989-631-6730
Mailing Address - Fax:989-631-4968
Practice Address - Street 1:3016 W WACKERLY ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-6160
Practice Address - Country:US
Practice Address - Phone:989-631-6730
Practice Address - Fax:989-631-4968
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704152768367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3502703Medicaid
MI4208754820OtherBCBSM
M74070Medicare UPIN