Provider Demographics
NPI:1134162720
Name:LYNCH, GAIL (FNP)
Entity type:Individual
Prefix:MS
First Name:GAIL
Middle Name:
Last Name:LYNCH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1038
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31902-1038
Mailing Address - Country:US
Mailing Address - Phone:706-321-3750
Mailing Address - Fax:762-821-2936
Practice Address - Street 1:7301 BLACKMON RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-4478
Practice Address - Country:US
Practice Address - Phone:706-321-3750
Practice Address - Fax:762-821-2936
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN097779363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN097779OtherLICENSE
GA500010891OtherRAILROAD MEDICARE
S72510Medicare UPIN