Healthcare Provider Details

I. General information

NPI: 1952370553
Provider Name (Legal Business Name): DR. JANE M LYNCH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 07/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 N COALTER ST SUITE 19
STAUNTON VA
24401-2551
US

IV. Provider business mailing address

1600 N COALTER ST SUITE 19
STAUNTON VA
24401-2551
US

V. Phone/Fax

Practice location:
  • Phone: 540-885-4500
  • Fax: 540-885-4600
Mailing address:
  • Phone: 540-885-4500
  • Fax: 540-885-4600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number0101-228437
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: