MEDICARE: LYNN EILERS CRNA

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	367500000X	Certified Registered Nurse Anesthetist	APRN9369351	FL
2	367500000X	Certified Registered Nurse Anesthetist	3098	CA

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	:	1972664589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNN EILERS CRNA

Provider Business Mailing Address
First Line	:	369 3RD ST
Second Line	:
City	:	ATLANTIC BEACH
State	:	FL
Zip	:	32233-5231
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	369 3RD ST
Second Line	:
City	:	ATLANTIC BEACH
State	:	FL
Zip	:	32233-5231
Country	:	US
Telephone Number	:	916-346-5709
Fax Number	:

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

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	04/14/2021

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