Healthcare Provider Details

I. General information

NPI: 1841970076
Provider Name (Legal Business Name): KATHRYN RHIANNON LYNN DNP, ACNPC-AG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2023
Last Update Date: 09/15/2023
Certification Date: 09/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 POPLAR AVE STE 800
MEMPHIS TN
38157-0800
US

IV. Provider business mailing address

8339 HUNTERS HOLLOW CV
BARTLETT TN
38002-8573
US

V. Phone/Fax

Practice location:
  • Phone: 901-276-2662
  • Fax:
Mailing address:
  • Phone: 832-928-3268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number226650
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number34494
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: