Provider Demographics
NPI:1811073471
Name:BRIGANTI, LYNN CAROL (RN, NP, APRN,BC)
Entity type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:CAROL
Last Name:BRIGANTI
Suffix:
Gender:F
Credentials:RN, NP, APRN,BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 VIA CERAMICA
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92673-7012
Mailing Address - Country:US
Mailing Address - Phone:949-481-5962
Mailing Address - Fax:
Practice Address - Street 1:5 VIA CERAMICA
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92673-7012
Practice Address - Country:US
Practice Address - Phone:949-481-5962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16138363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABI248YMedicare PIN
CABI248XMedicare PIN
CABI736ZMedicare PIN