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General NPI Number Information
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NPI Number | 1962136515
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Entity Type | Individual
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Provider Name | LYNSEY RANK FNP
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Gender | Female
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Dates
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Enumeration Date | 07/11/2022
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Last Update Date | 07/11/2022
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Provider Practice Location Address
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Address Line | 96 TARA COMMONS DR
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City | LOGANVILLE
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State | GA
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Zip | 30052-8031
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Country | US
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Telephone | 770-554-0399
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Fax |
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Provider Business Mailing Address
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Address Line | 6024 COLE LN
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City | LOGANVILLE
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State | GA
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Zip | 30052-9277
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Country | US
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Telephone | 678-215-2546
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | RN238772
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License Number State | GA
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