MEDICARE: STORY LEE LYNCH AGNP-C

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	AG01170222	MO
2	363LG0600X	Gerontology Nurse Practitioner	2017013256	MO

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578001038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STORY LEE LYNCH AGNP-C

Provider Business Mailing Address
First Line	:	101 MOSAIC CT STE 200
Second Line	:
City	:	SAINT JOSEPH
State	:	MO
Zip	:	64506-0015
Country	:	US
Telephone Number	:	816-271-1350
Fax Number	:	816-271-1355

Provider Business Practice Location Address
First Line	:	101 MOSAIC CT STE 200
Second Line	:
City	:	SAINT JOSEPH
State	:	MO
Zip	:	64506-0015
Country	:	US
Telephone Number	:	816-271-1350
Fax Number	:	816-271-1355

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

Provider Enumeration Date	:	02/05/2017
Last Update Date	:	04/06/2026

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Directions to “ STORY LEE LYNCH AGNP-C” Practice Location

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