Healthcare Provider Details

I. General information

NPI: 1023795960
Provider Name (Legal Business Name): JONNA RAE LYNCH DNP, NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2023
Last Update Date: 07/03/2023
Certification Date: 07/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 S 48TH ST
LINCOLN NE
68506-1283
US

IV. Provider business mailing address

1000 S 35TH ST
LINCOLN NE
68510-3460
US

V. Phone/Fax

Practice location:
  • Phone: 402-481-7327
  • Fax:
Mailing address:
  • Phone: 605-939-8895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number114832
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: