Provider Demographics
NPI:1295893048
Name:FROMM, LYNN E (ARNP)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:E
Last Name:FROMM
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S 8TH ST
Mailing Address - Street 2:SUITE 382
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-2400
Mailing Address - Country:US
Mailing Address - Phone:270-753-7463
Mailing Address - Fax:270-767-3638
Practice Address - Street 1:300 S 8TH ST
Practice Address - Street 2:SUITE 382
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-2400
Practice Address - Country:US
Practice Address - Phone:270-753-7463
Practice Address - Fax:270-767-3638
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2202P363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYCK4330OtherMEDICARE RAILROAD
KY6885OtherMEDICARE GROUP
KY78004736Medicaid
KY78004736Medicaid