Individual
SHANNON C LYNCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7810 DAVENPORT ST, OMAHA, NE 68114-3629
(402) 397-1626
(402) 397-1286
Mailing address
7810 DAVENPORT ST, OMAHA, NE 68114-3629
(402) 397-1626
(402) 397-1286
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
35612
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025269300
—
NE
01
—
1440172
IA MEDICAID
IA
01
—
P00255927
RR MEDICARE
NE
Enumeration date
05/10/2006
Last updated
10/18/2007
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