Provider Demographics
NPI:1841554060
Name:LYNCH-SMITH, DONNA JO (DNP ACNP)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:JO
Last Name:LYNCH-SMITH
Suffix:
Gender:F
Credentials:DNP ACNP
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:JO
Other - Last Name:LYNCH-SMITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:09/23/1955
Mailing Address - Street 1:877 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-3408
Mailing Address - Country:US
Mailing Address - Phone:901-448-4152
Mailing Address - Fax:
Practice Address - Street 1:877 MADISON AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-3408
Practice Address - Country:US
Practice Address - Phone:901-448-4152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-03
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16378363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care