Individual
LYNN ANN NOVAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MLT ASCP
Contact information
Practice address
111 WASHINGTON AVE NW, WAGNER, SD 57380
(605) 384-3621
(605) 384-3293
Mailing address
111 WASHINGTON AVE NW, WAGNER, SD 57380
(605) 384-3621
(605) 384-3293
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
53427
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5540030
—
SD
05
—
5540100
—
SD
Enumeration date
05/14/2007
Last updated
07/09/2007
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