Healthcare Provider Details

I. General information

NPI: 1558969998
Provider Name (Legal Business Name): MARGEAUX LYNN GERMAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARGEAUX LYNN LIPPMANN

II. Dates (important events)

Enumeration Date: 10/16/2020
Last Update Date: 06/22/2021
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 SHERIDAN ST UNIT U
HOLLYWOOD FL
33021-3420
US

IV. Provider business mailing address

11040 GLENWOOD DR
CORAL SPRINGS FL
33065-7734
US

V. Phone/Fax

Practice location:
  • Phone: 954-505-4458
  • Fax: 954-367-3495
Mailing address:
  • Phone: 954-298-2713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9342470
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11009800
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: