Provider Demographics
NPI:1093521064
Name:LYNCH, WENDY SUMIE (PA)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:SUMIE
Last Name:LYNCH
Suffix:
Gender:
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 OAK RIDGE PL APT 12M
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-5084
Mailing Address - Country:US
Mailing Address - Phone:843-509-9906
Mailing Address - Fax:
Practice Address - Street 1:2126 HIGHWAY 81 N
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1532
Practice Address - Country:US
Practice Address - Phone:864-226-2660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-05
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical