Provider Demographics
NPI:1255773578
Name:MASIH, LYNN ABRAHAM (FNP-BC)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:ABRAHAM
Last Name:MASIH
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3905 NATIONAL DR STE 210
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-6106
Mailing Address - Country:US
Mailing Address - Phone:301-476-9000
Mailing Address - Fax:301-476-9006
Practice Address - Street 1:3905 NATIONAL DR STE 210
Practice Address - Street 2:
Practice Address - City:BURTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20866-6106
Practice Address - Country:US
Practice Address - Phone:301-476-9000
Practice Address - Fax:301-476-9006
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-28
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR148773363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily