Provider Demographics
NPI:1811965254
Name:DEVLIN, LYNN A (PA-C)
Entity type:Individual
Prefix:MS
First Name:LYNN
Middle Name:A
Last Name:DEVLIN
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 29048
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85038-9048
Mailing Address - Country:US
Mailing Address - Phone:505-216-3615
Mailing Address - Fax:505-747-6816
Practice Address - Street 1:8201 GOLF COURSE RD NW STE D
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-5842
Practice Address - Country:US
Practice Address - Phone:505-800-7070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4181363AM0700X
NMPA2008-0033363AM0700X
NY008335363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM82737321Medicaid
NM271090YLKBMedicare PIN
Q08561Medicare UPIN
NM82737321Medicaid