Healthcare Provider Details

I. General information

NPI: 1912645706
Provider Name (Legal Business Name): LYNN HEALTH CONSULTANT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2022
Last Update Date: 05/23/2022
Certification Date: 05/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1619 28TH PL SE
WASHINGTON DC
20020-3809
US

IV. Provider business mailing address

1619 28TH PL SE
WASHINGTON DC
20020-3809
US

V. Phone/Fax

Practice location:
  • Phone: 202-255-2574
  • Fax:
Mailing address:
  • Phone: 202-255-2574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: LYNJULLIE AUGUSTINE NKWABA
Title or Position: CEO
Credential:
Phone: 202-255-2574