Healthcare Provider Details

I. General information

NPI: 1114976487
Provider Name (Legal Business Name): LYNN ANDERSON APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2006
Last Update Date: 08/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1664 N VIRGINIA ST # MS 152
RENO NV
89557
US

IV. Provider business mailing address

PO BOX 2350
RENO NV
89505-2350
US

V. Phone/Fax

Practice location:
  • Phone: 775-784-4414
  • Fax: 775-784-4468
Mailing address:
  • Phone: 775-784-1223
  • Fax: 775-327-2009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN12861
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPN000686
License Number StateNV
# 3
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberAPN000686
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: