MEDICARE: LYNNE G. ATWOOD CNM, CFNP

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	363LF0000X	Family Nurse Practitioner	204915-4405	UT
2	363LX0001X	Obstetrics & Gynecology Nurse Practitioner	204915-4402	UT

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

General Provider Information

NPI Number	:	1275590960
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNNE G. ATWOOD CNM, CFNP

Provider Business Mailing Address
First Line	:	4052 W 3390 S
Second Line	:	SUITE # 205
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84120-2062
Country	:	US
Telephone Number	:	801-964-3758
Fax Number	:	801-964-3797

Provider Business Practice Location Address
First Line	:	4052 W 3390 S
Second Line	:	SUITE # 205
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84120-2062
Country	:	US
Telephone Number	:	801-964-3758
Fax Number	:	801-964-3797

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

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	09/11/2025

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