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Individual
MR. MICHAEL LYNN
Active
Individual
MR. MICHAEL LYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
122180
CO
363LA2100X
Acute Care Nurse Practitioner
NP-941
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
122180
NURSING LICENSE #
CO
01
—
NP-941
IDAHO NURSING LICENSE
ID
Enumeration date
03/06/2007
Last updated
11/13/2012
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