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General NPI Number Information
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NPI Number | 1215652276
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Entity Type | Individual
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Provider Name | NICHOLE LYNCH APRN
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Gender | Female
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Dates
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Enumeration Date | 10/11/2022
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Last Update Date | 10/20/2022
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Provider Practice Location Address
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Address Line | 260 BETH STACEY BLVD UNIT 130
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City | LEHIGH ACRES
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State | FL
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Zip | 33936-6074
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Country | US
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Telephone | 239-368-2839
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Fax | 239-368-5011
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Provider Business Mailing Address
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Address Line | 2675 WINKLER AVE FL 2
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City | FORT MYERS
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State | FL
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Zip | 33901-9342
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Country | US
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Telephone | 877-856-3774
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11022367
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License Number State | FL
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