Provider Demographics
NPI:1396067229
Name:LYNCH, KENYA MICHELLE (LPN)
Entity type:Individual
Prefix:
First Name:KENYA
Middle Name:MICHELLE
Last Name:LYNCH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2251 EMERSON AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45406-3024
Mailing Address - Country:US
Mailing Address - Phone:937-397-3367
Mailing Address - Fax:
Practice Address - Street 1:2251 EMERSON AVE APT 1
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406-3024
Practice Address - Country:US
Practice Address - Phone:937-397-3367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-19
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN. 123408 IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse