MEDICARE: LYNN VAN EPPS CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	AP131499	TX
2	363LA2200X	Adult Health Nurse Practitioner	APRN.CNP.15157	OH
3	363LA2200X	Adult Health Nurse Practitioner	NP-15157	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	9338635	OTHER	OH	PARTNERS PHYSICIAN GROUP MEDICARE GROUP #

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073942660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNN VAN EPPS CNP

Provider Business Mailing Address
First Line	:	6101 BLUE LAGOON DR STE 200
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-3168
Country	:	US
Telephone Number	:	615-705-1725
Fax Number	:	864-725-7707

Provider Business Practice Location Address
First Line	:	9727 POTEET JOURDANTON FWY STE 108
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78211-4575
Country	:	US
Telephone Number	:	210-923-4372
Fax Number	:	210-923-5581

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2013
Last Update Date	:	10/12/2022

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