=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811962822
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JANET C LYNN AU.D. AUDIOLOGIST
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/22/2006
-----------------------------------------------------
Last Update Date | 10/13/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 925 HIGHWAY 55 CENTRAL COMMONS BLDG, SUITE 103
-----------------------------------------------------
City | HASTINGS
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55033-3734
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 651-503-7372
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 925 HIGHWAY 55 CENTRAL COMMONS BLDG, SUITE 103
-----------------------------------------------------
City | HASTINGS
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55033-3734
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 651-503-7372
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 231H00000X
-----------------------------------------------------
Taxonomy Name | Audiologist
-----------------------------------------------------
License Number | 5022
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------