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NPI Code Detail

MEDICARE: BRETT DUKE LYNAM APRN

MEDICARE: BRETT DUKE LYNAM APRN
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
1363LF0000XFamily Nurse Practitioner22852SC

Other Identifiers

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

General Provider Information

NPI Number : 1780246348
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRETT DUKE LYNAM APRN
Provider Business Mailing Address
First Line : 300 E MCBEE AVE FL 4
Second Line :
City : GREENVILLE
State : SC
Zip : 29601-2842
Country : US
Telephone Number : 864-522-8603
Fax Number :
Provider Business Practice Location Address
First Line : 129 N WASHINGTON ST
Second Line :
City : SUMTER
State : SC
Zip : 29150-4949
Country : US
Telephone Number : 803-774-9680
Fax Number : 803-434-3955
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2019
Last Update Date : 02/09/2026

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