Provider Demographics
NPI:1952649642
Name:PATEL, LYNN ASHLEY (ARNP)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:ASHLEY
Last Name:PATEL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2035 PROFESSIONAL CENTER DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-4492
Mailing Address - Country:US
Mailing Address - Phone:904-272-3200
Mailing Address - Fax:904-272-3211
Practice Address - Street 1:1658 ST VINCENTS WAY STE 200
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:FL
Practice Address - Zip Code:32068-8459
Practice Address - Country:US
Practice Address - Phone:904-272-3200
Practice Address - Fax:904-272-3211
Is Sole Proprietor?:No
Enumeration Date:2013-01-30
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9264601363LF0000X
FLARPN9264601363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily