MEDICARE: LYNDON ABROGAR 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	163W00000X	Registered Nurse	693684	CA
2	163WW0000X	Wound Care Registered Nurse	4244	FL
3	163WC0400X	Case Management Registered Nurse	4229763	NJ

General Provider Information

NPI Number	:	1992220941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNDON ABROGAR RN

Provider Business Mailing Address
First Line	:	1984 HORSESHOE GLEN CIR
Second Line	:
City	:	FOLSOM
State	:	CA
Zip	:	95630-6293
Country	:	US
Telephone Number	:	916-983-6403
Fax Number	:

Provider Business Practice Location Address
First Line	:	1984 HORSESHOE GLEN CIR
Second Line	:
City	:	FOLSOM
State	:	CA
Zip	:	95630-6293
Country	:	US
Telephone Number	:	916-983-6403
Fax Number	:

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

Provider Enumeration Date	:	08/11/2017
Last Update Date	:	07/21/2022

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