Provider Demographics
NPI:1952990939
Name:HEARNE, LYNN M (RPH)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:M
Last Name:HEARNE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:563 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-2903
Mailing Address - Country:US
Mailing Address - Phone:978-263-3901
Mailing Address - Fax:978-263-2305
Practice Address - Street 1:563 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-2903
Practice Address - Country:US
Practice Address - Phone:978-263-3901
Practice Address - Fax:978-263-2305
Is Sole Proprietor?:No
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19672183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist