Provider Demographics
NPI:1811123607
Name:PIKE, LYNN MARIE (LPN)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:MARIE
Last Name:PIKE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 ZEPHER WAY
Mailing Address - Street 2:25 ZEPHER WAY
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95966-3749
Mailing Address - Country:US
Mailing Address - Phone:530-533-2319
Mailing Address - Fax:530-533-2319
Practice Address - Street 1:25 ZEPHER WAY
Practice Address - Street 2:25 ZEPHER WAY
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95966-3749
Practice Address - Country:US
Practice Address - Phone:530-533-2319
Practice Address - Fax:530-533-2319
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-07
Last Update Date:2009-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN 231499164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse