Provider Demographics
NPI:1821816125
Name:LYNCH, CHRISTIAN MICHAEL (PRSS)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:MICHAEL
Last Name:LYNCH
Suffix:
Gender:
Credentials:PRSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 S PRATT AVE
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89701-4730
Mailing Address - Country:US
Mailing Address - Phone:775-882-3945
Mailing Address - Fax:775-882-6126
Practice Address - Street 1:788 FAIRVIEW DR
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89701-5790
Practice Address - Country:US
Practice Address - Phone:775-882-3945
Practice Address - Fax:775-882-6126
Is Sole Proprietor?:No
Enumeration Date:2024-09-26
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPRSS-INT-5169175T00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No175T00000XOther Service ProvidersPeer Specialist