Healthcare Provider Details

I. General information

NPI: 1619894250
Provider Name (Legal Business Name): ASHLYN NICOLE LYNARD RN IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4909 N BASSWOOD AVE
MERIDIAN ID
83646-7712
US

IV. Provider business mailing address

4909 N BASSWOOD AVE
MERIDIAN ID
83646-7712
US

V. Phone/Fax

Practice location:
  • Phone: 208-353-0116
  • Fax:
Mailing address:
  • Phone: 208-353-0116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number75349
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: