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Individual

LYNSEY BRIANE MAHLUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
1801 16TH ST, GREELEY, CO 80631-5154
(970) 350-6953
(970) 350-6965
Mailing address
1405 SOUTH 8TH AVENUE, BANNER HEALTH CLINIC SURGICAL SPECIALTIES, STERLING, CO 80751
(970) 526-8123

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP60192019
WA
363LA2200X
Adult Health Nurse Practitioner
Primary
APN.0991119-NP
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1528362340
WA
Enumeration date
01/08/2011
Last updated
06/12/2014
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