Individual
LYNN ELLEN ADDIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1995 TECHNOLOGY PKWY, MECHANICSBURG, PA 17050-8522
(717) 782-3380
(717) 782-5716
Mailing address
409 S 2ND ST, SUITE 2F, HARRISBURG, PA 17104-1612
(717) 782-3380
(717) 782-5716
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
VP006619B
PA
363LF0000X
Family Nurse Practitioner
Primary
VP006619B
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102654131
—
PA
01
—
1602875
GATEWAY MEDICARE ASSURED
PA
01
—
2677086
HIGHMARK BLUE SHIELD - FREEDOM BLUE
PA
Enumeration date
05/30/2006
Last updated
05/13/2019
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