Individual
MRS. LYNN OMALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
297 INDEPENDENCE BLVD, SUITE 126, VIRGINIA BEACH, VA 23462-2911
(757) 385-0511
(757) 497-6201
Mailing address
1015 COLONIAL AVE, NORFOLK, VA 23507-1727
(757) 589-9981
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
0024166859
VA
363LF0000X
Family Nurse Practitioner
NN067472
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861562472
—
VA
01
—
NN067472
NP LICENSE
NJ
Enumeration date
04/11/2006
Last updated
07/28/2014
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