Provider Demographics
NPI:1457522476
Name:GARZA, LYNN ANGELIQUE (NP)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:ANGELIQUE
Last Name:GARZA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:ANGELIQUE
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:407 S CLAIRBORNE RD STE 104
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-1744
Mailing Address - Country:US
Mailing Address - Phone:855-886-6938
Mailing Address - Fax:
Practice Address - Street 1:407 S CLAIRBORNE RD STE 104
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1744
Practice Address - Country:US
Practice Address - Phone:855-886-6938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-18
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS46221363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily