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NPI Code Detail

MEDICARE: LYNNE A KOEHN

MEDICARE: LYNNE A KOEHN
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
1183500000XPharmacist1-11209KS

General Provider Information

NPI Number : 1659860666
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNNE A KOEHN
Provider Business Mailing Address
First Line : 2013 CIRCLE LAKE DR
Second Line :
City : DODGE CITY
State : KS
Zip : 67801-2979
Country : US
Telephone Number : 620-408-5296
Fax Number :
Provider Business Practice Location Address
First Line : 1905 N 14TH AVE
Second Line :
City : DODGE CITY
State : KS
Zip : 67801-2304
Country : US
Telephone Number : 620-225-0872
Fax Number : 620-225-0717
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2018
Last Update Date : 05/04/2018

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Directions to “ LYNNE A KOEHN ” Practice Location

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