Healthcare Provider Details

I. General information

NPI: 1871034405
Provider Name (Legal Business Name): LYNN HOTALING NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2017
Last Update Date: 06/28/2024
Certification Date: 06/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6339 MILL ST
RHINEBECK NY
12572-1427
US

IV. Provider business mailing address

6339 MILL ST
RHINEBECK NY
12572-1427
US

V. Phone/Fax

Practice location:
  • Phone: 845-871-1057
  • Fax:
Mailing address:
  • Phone: 845-871-1057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number716310-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number406051
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: