Individual
SHANNON C LYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
825 BARRET AVE, LOUISVILLE, KY 40204-1743
(502) 540-7200
(502) 540-7207
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
38201
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000298643
ANTHEM / NCMA
—
01
—
0000264470
HUMANA / NCMA
—
01
—
023378
SIHO / NCMA
—
01
—
1205618
CHA / NCMA
—
05
—
200447010
—
IN
01
—
2443113000
PASSPORT ADVANTAGE / NCMA
—
01
—
50001528
PASSPORT / NCMA
—
05
—
64067911
—
KY
01
—
8634556
CIGNA / NCMA
—
01
—
P00107214
MCR - RR
KY
Enumeration date
04/17/2006
Last updated
08/18/2016
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