Provider Demographics
NPI:1770779068
Name:MCKENRY, LYNDA MARIE (ARNP CNM)
Entity type:Individual
Prefix:MS
First Name:LYNDA
Middle Name:MARIE
Last Name:MCKENRY
Suffix:
Gender:F
Credentials:ARNP CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5422 US HIGHWAY 19
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-3948
Mailing Address - Country:US
Mailing Address - Phone:727-849-1659
Mailing Address - Fax:727-842-3627
Practice Address - Street 1:5422 US HIGHWAY 19
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-3948
Practice Address - Country:US
Practice Address - Phone:727-849-1659
Practice Address - Fax:727-842-3627
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 3104782364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist