Individual
SHANE LYNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
2710 PALM HARBOR BLVD # 403B, PALM HARBOR, FL 34683-2666
(277) 275-3601
(727) 238-8137
Mailing address
2710 ALTERNATE 19 N 403B, PALM HARBOR, FL 34683-5915
(727) 275-3601
(727) 238-8137
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP129984
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN9398198
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7276414435
NEW GRADUATE
FL
Enumeration date
06/27/2016
Last updated
11/26/2021
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