Healthcare Provider Details

I. General information

NPI: 1295411197
Provider Name (Legal Business Name): ERIKA LYNCH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 07/17/2024
Certification Date: 06/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

189 ANDREW DRIVE
ONEIDA TN
37841
US

IV. Provider business mailing address

189 ANDREW ST
ONEIDA TN
37841-6296
US

V. Phone/Fax

Practice location:
  • Phone: 423-569-3762
  • Fax:
Mailing address:
  • Phone: 423-319-6829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number34151
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: