Provider Demographics
NPI:1750152948
Name:HRICIK, LYNNE ROCHELLE
Entity type:Individual
Prefix:MS
First Name:LYNNE
Middle Name:ROCHELLE
Last Name:HRICIK
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:LYNNE
Other - Middle Name:
Other - Last Name:DURNELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:501 JACKSON BLVD
Mailing Address - Street 2:
Mailing Address - City:FREEDOM
Mailing Address - State:PA
Mailing Address - Zip Code:15042-2842
Mailing Address - Country:US
Mailing Address - Phone:724-774-3050
Mailing Address - Fax:
Practice Address - Street 1:213 EXECUTIVE DR STE 240
Practice Address - Street 2:
Practice Address - City:CRANBERRY TWP
Practice Address - State:PA
Practice Address - Zip Code:16066-6405
Practice Address - Country:US
Practice Address - Phone:724-772-9797
Practice Address - Fax:724-772-3309
Is Sole Proprietor?:No
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA00946L207QA0505X
PAMA000946L363AM0700X
PA1010116363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine