Provider Demographics
NPI:1508898826
Name:AILOR, LYNNE POWERS (NP)
Entity Type:Individual
Prefix:
First Name:LYNNE
Middle Name:POWERS
Last Name:AILOR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 BLACKWATER TRL
Mailing Address - Street 2:
Mailing Address - City:CARET
Mailing Address - State:VA
Mailing Address - Zip Code:22436-2241
Mailing Address - Country:US
Mailing Address - Phone:804-443-6979
Mailing Address - Fax:540-371-3753
Practice Address - Street 1:600 JACKSON ST
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-5719
Practice Address - Country:US
Practice Address - Phone:540-899-4371
Practice Address - Fax:540-371-3753
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024165972363LP0808X
VA001500756364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005675D78Medicare ID - Type Unspecified
Q27187Medicare UPIN