Healthcare Provider Details

I. General information

NPI: 1427151216
Provider Name (Legal Business Name): LYNN MCGRATH CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 HOLLAND ST LAKE ERIE WOMENS CENTER
ERIE PA
16507
US

IV. Provider business mailing address

5331 CHERRY ST
ERIE PA
16509
US

V. Phone/Fax

Practice location:
  • Phone: 814-453-5058
  • Fax: 814-452-4174
Mailing address:
  • Phone: 814-868-1062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberVP001584G
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: