Healthcare Provider Details

I. General information

NPI: 1811496821
Provider Name (Legal Business Name): LYNN M KROPP NP, AGNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LYNN ADAMS RN

II. Dates (important events)

Enumeration Date: 02/05/2018
Last Update Date: 10/17/2023
Certification Date: 10/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20414 N 27TH AVE FL 5
PHOENIX AZ
85027-3250
US

IV. Provider business mailing address

20414 N 27TH AVE FL 5
PHOENIX AZ
85027-3250
US

V. Phone/Fax

Practice location:
  • Phone: 623-869-5000
  • Fax:
Mailing address:
  • Phone: 623-869-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number260888
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number260888
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209.017216
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: