Healthcare Provider Details

I. General information

NPI: 1467938266
Provider Name (Legal Business Name): MICHAEL LYNCH APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2018
Last Update Date: 01/05/2021
Certification Date: 01/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

386 STANLEY ST
FALL RIVER MA
02720
US

IV. Provider business mailing address

386 STANLEY ST
FALL RIVER MA
02720-6009
US

V. Phone/Fax

Practice location:
  • Phone: 508-679-5222
  • Fax: 508-673-3182
Mailing address:
  • Phone: 508-324-3550
  • Fax: 508-676-5671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number3150882
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2230437
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: