Provider Demographics
NPI:1336801950
Name:LYNCH, KATHLEENE ANNETTE
Entity Type:Individual
Prefix:
First Name:KATHLEENE
Middle Name:ANNETTE
Last Name:LYNCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 CATHEDRAL AVE NW APT 708W
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-4964
Mailing Address - Country:US
Mailing Address - Phone:202-657-2799
Mailing Address - Fax:
Practice Address - Street 1:4201 CATHEDRAL AVE. NW #708W
Practice Address - Street 2:516E
Practice Address - City:WASHINGTON DC
Practice Address - State:DC
Practice Address - Zip Code:20016-2001
Practice Address - Country:US
Practice Address - Phone:202-657-2799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-11
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant