Healthcare Provider Details

I. General information

NPI: 1518900604
Provider Name (Legal Business Name): NANCY S LYNCH APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 03/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 DRY HILL ROAD
BECKLEY WV
25801
US

IV. Provider business mailing address

275 DRY HILL ROAD
BECKLEY WV
25801
US

V. Phone/Fax

Practice location:
  • Phone: 304-253-6060
  • Fax: 304-929-2248
Mailing address:
  • Phone: 304-253-6060
  • Fax: 304-929-2248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number038800122
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number25477
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: