Provider Demographics
NPI:1689629842
Name:LYNN, MADELINE S (CRNP)
Entity type:Individual
Prefix:MS
First Name:MADELINE
Middle Name:S
Last Name:LYNN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6620 CYPRESSWOOD DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-7746
Mailing Address - Country:US
Mailing Address - Phone:281-477-8660
Mailing Address - Fax:
Practice Address - Street 1:6620 CYPRESSWOOD DR
Practice Address - Street 2:SUITE 200
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-7746
Practice Address - Country:US
Practice Address - Phone:281-477-8660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX799088363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX799088OtherNNP