Provider Demographics
NPI:1881700599
Name:BROOKES, LYNN (NP)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:BROOKES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 E. HWY 20
Mailing Address - Street 2:
Mailing Address - City:LUCERNE
Mailing Address - State:CA
Mailing Address - Zip Code:95458
Mailing Address - Country:US
Mailing Address - Phone:707-274-9299
Mailing Address - Fax:
Practice Address - Street 1:6300 E. HWY 20
Practice Address - Street 2:
Practice Address - City:LUCERNE
Practice Address - State:CA
Practice Address - Zip Code:95458
Practice Address - Country:US
Practice Address - Phone:707-274-9299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP3832363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA3832OtherNP#
CA364607OtherRN#
CAMB0624519OtherDEA NUMBER
CA3832OtherNP#
CAPI4432Medicare UPIN
CAZZZ05093ZMedicare PIN