Healthcare Provider Details

I. General information

NPI: 1750668760
Provider Name (Legal Business Name): ASIA LYNN FOUNTAIN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2011
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5432 MAYFIELD RD STE 205
LYNDHURST OH
44124-2930
US

IV. Provider business mailing address

51 PIN OAK CIR
NORTHFIELD OH
44067-2787
US

V. Phone/Fax

Practice location:
  • Phone: 440-421-9256
  • Fax: 216-352-0100
Mailing address:
  • Phone: 216-849-2480
  • Fax: 216-352-0100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number362903
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: