Individual
MS. LYNNELLE DRIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
411 W TIPTON ST, SEYMOUR, IN 47274-2363
(812) 523-5862
(812) 523-4753
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10000505A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000374100
ANTHEM PIN NUMBER
IN
05
—
201252530
—
IN
Enumeration date
08/01/2006
Last updated
04/25/2024
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