MEDICARE: MS. LYNN GIVENS RN

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	163WM0705X	Medical-Surgical Registered Nurse	RN209551	OH

General Provider Information

NPI Number	:	1457628349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LYNN GIVENS RN

Provider Business Mailing Address
First Line	:	6731 WEST BLVD
Second Line	:
City	:	BOARDMAN
State	:	OH
Zip	:	44512-4130
Country	:	US
Telephone Number	:	330-398-7101
Fax Number	:

Provider Business Practice Location Address
First Line	:	6731 WEST BLVD
Second Line	:
City	:	BOARDMAN
State	:	OH
Zip	:	44512-4130
Country	:	US
Telephone Number	:	330-398-7101
Fax Number	:

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

Provider Enumeration Date	:	11/21/2011
Last Update Date	:	11/21/2011

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