MEDICARE: LYNNE SWINK ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	ARNP9253751	FL
2	363L00000X	Nurse Practitioner	ARNP9253751	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194260216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNNE SWINK ARNP

Provider Business Mailing Address
First Line	:	6822 22ND AVE N # 169
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33710-3918
Country	:	US
Telephone Number	:	727-404-2496
Fax Number	:

Provider Business Practice Location Address
First Line	:	4146 4TH AVE N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33713-7410
Country	:	US
Telephone Number	:	727-482-8832
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2016
Last Update Date	:	12/16/2021

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