Healthcare Provider Details

I. General information

NPI: 1689226508
Provider Name (Legal Business Name): LYNN MICHELLE HOERRES FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2019
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8851 CENTER DR STE 505
LA MESA CA
91942-3059
US

IV. Provider business mailing address

4225 EXECUTIVE SQ STE 450
LA JOLLA CA
92037-8411
US

V. Phone/Fax

Practice location:
  • Phone: 619-461-3880
  • Fax: 619-461-3895
Mailing address:
  • Phone: 858-810-8000
  • Fax: 858-268-1911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP019374
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: