Healthcare Provider Details

I. General information

NPI: 1437928835
Provider Name (Legal Business Name): LYNN RENEE COLLINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2023
Last Update Date: 12/27/2023
Certification Date: 12/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 HARRISBURG PIKE
LANCASTER PA
17601-2644
US

IV. Provider business mailing address

320 DEAN ST APT 2
WEST CHESTER PA
19382-3321
US

V. Phone/Fax

Practice location:
  • Phone: 717-544-2935
  • Fax:
Mailing address:
  • Phone: 717-644-3660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: