Provider Demographics
NPI:1023107125
Name:HERMAN, LYNNE D (ANP)
Entity type:Individual
Prefix:MRS
First Name:LYNNE
Middle Name:D
Last Name:HERMAN
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1703 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-3077
Mailing Address - Country:US
Mailing Address - Phone:423-499-0228
Mailing Address - Fax:
Practice Address - Street 1:3555 BROAD ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37409-1028
Practice Address - Country:US
Practice Address - Phone:423-756-8808
Practice Address - Fax:423-756-4397
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000008079363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily