Healthcare Provider Details

I. General information

NPI: 1427448448
Provider Name (Legal Business Name): SONJA NAOMI LYNTON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2015
Last Update Date: 02/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 PROFESSIONAL CT SUITE P
HAGERSTOWN MD
21740-4100
US

IV. Provider business mailing address

PO BOX 74166
CLEVELAND OH
44194-4166
US

V. Phone/Fax

Practice location:
  • Phone: 301-665-9696
  • Fax: 240-420-5715
Mailing address:
  • Phone: 301-665-9696
  • Fax: 240-420-5715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF07141285
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: