MEDICARE: DR. LYNN ANN MAINOLFI DNP, CRNP

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	SP-008759	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	257229PTD	OTHER		MEDICARE

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	:	1336226042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LYNN ANN MAINOLFI DNP, CRNP

Provider Business Mailing Address
First Line	:	203 MEADOW BROOK LN
Second Line	:
City	:	HARMONY
State	:	PA
Zip	:	16037-9179
Country	:	US
Telephone Number	:	412-498-4277
Fax Number	:

Provider Business Practice Location Address
First Line	:	12450 PERRY HWY
Second Line	:
City	:	WEXFORD
State	:	PA
Zip	:	15090-7387
Country	:	US
Telephone Number	:	724-933-5100
Fax Number	:	724-933-4076

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	02/24/2016

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