Provider Demographics
NPI:1013483296
Name:BARRETT, LYNCEE ANNE (FNP)
Entity Type:Individual
Prefix:
First Name:LYNCEE
Middle Name:ANNE
Last Name:BARRETT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:LYNCEE ANNE
Other - Middle Name:LAZARTE
Other - Last Name:DADIVAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:43 NEW SCOTLAND AVE # MC131
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3478
Mailing Address - Country:US
Mailing Address - Phone:518-262-4305
Mailing Address - Fax:
Practice Address - Street 1:43 NEW SCOTLAND AVE # MC131
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3478
Practice Address - Country:US
Practice Address - Phone:518-262-4305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-16
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF343670-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily