Provider Demographics
NPI:1336226042
Name:MAINOLFI, LYNN ANN (DNP, CRNP)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:ANN
Last Name:MAINOLFI
Suffix:
Gender:F
Credentials:DNP, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 MEADOW BROOK LN
Mailing Address - Street 2:
Mailing Address - City:HARMONY
Mailing Address - State:PA
Mailing Address - Zip Code:16037-9179
Mailing Address - Country:US
Mailing Address - Phone:412-498-4277
Mailing Address - Fax:
Practice Address - Street 1:12450 PERRY HWY
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-7387
Practice Address - Country:US
Practice Address - Phone:724-933-5100
Practice Address - Fax:724-933-4076
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP-008759363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1024704570001Medicaid
257229PTDOtherMEDICARE