Provider Demographics
NPI:1598645814
Name:LYNCH, JAZZLYN (CNA)
Entity type:Individual
Prefix:
First Name:JAZZLYN
Middle Name:
Last Name:LYNCH
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 PADDOCK DR W
Mailing Address - Street 2:
Mailing Address - City:SAVOY
Mailing Address - State:IL
Mailing Address - Zip Code:61874-9609
Mailing Address - Country:US
Mailing Address - Phone:217-819-6475
Mailing Address - Fax:
Practice Address - Street 1:614 W HEALEY ST
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61820-5025
Practice Address - Country:US
Practice Address - Phone:217-819-6475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty