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General NPI Number Information
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NPI Number | 1720097108
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Entity Type | Individual
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Provider Name | LYNN JEHLE NP
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Gender | Female
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 01/29/2018
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Provider Practice Location Address
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Address Line | 2850 TELEGRAPH AVE STE 110
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City | BERKELEY
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State | CA
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Zip | 94705-1159
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Country | US
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Telephone | 510-204-8140
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Fax | 510-849-0159
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Provider Business Mailing Address
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Address Line | 2850 TELEGRAPH AVE STE 110
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City | BERKELEY
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State | CA
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Zip | 94705-1159
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Country | US
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Telephone | 510-204-8140
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Fax | 510-849-0159
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 9271
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License Number State | CA
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