Provider Demographics
NPI:1265257513
Name:LYNCH, LORRAINE (CNA)
Entity type:Individual
Prefix:
First Name:LORRAINE
Middle Name:
Last Name:LYNCH
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4345 DUFFY DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-7950
Mailing Address - Country:US
Mailing Address - Phone:757-404-5794
Mailing Address - Fax:
Practice Address - Street 1:4345 DUFFY DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-7950
Practice Address - Country:US
Practice Address - Phone:757-404-5794
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1401228924374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide