Provider Demographics
NPI:1265412316
Name:DEES, LYNN M (CRNP)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:M
Last Name:DEES
Suffix:
Gender:F
Credentials:CRNP
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 64442
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4442
Mailing Address - Country:US
Mailing Address - Phone:410-328-5122
Mailing Address - Fax:410-328-0479
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1544
Practice Address - Country:US
Practice Address - Phone:410-328-5122
Practice Address - Fax:410-328-0479
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN960460363L00000X
MDR102642363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS062-0418OtherBC/BS REGIONAL
MD972175-01OtherBLUE CROSS/BLUE SHIELD
MDS062-0418OtherBC/BS REGIONAL
MD203959Y3WMedicare PIN