Provider Demographics
NPI:1265557706
Name:ZINK, LYNN (NP)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:ZINK
Suffix:
Gender:F
Credentials:NP
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 227
Mailing Address - Street 2:
Mailing Address - City:NEWTON GROVE
Mailing Address - State:NC
Mailing Address - Zip Code:28366-0227
Mailing Address - Country:US
Mailing Address - Phone:910-567-6194
Mailing Address - Fax:910-567-5342
Practice Address - Street 1:341A WHITEVILLE RD NW
Practice Address - Street 2:
Practice Address - City:SHALLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28470-4507
Practice Address - Country:US
Practice Address - Phone:910-567-6194
Practice Address - Fax:910-567-5342
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704196933363L00000X
NC5008223363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4988590Medicaid
MI4988615Medicaid
LZ196933OtherBLUE CROSS BLUE SHIELD
P00429854OtherRAILROAD MEDICARE
MI4988624Medicaid
MIB56088103Medicare Oscar/Certification
P00429854OtherRAILROAD MEDICARE