Provider Demographics
NPI:1124891536
Name:MUNSELLE, LYNNETTE (RN)
Entity type:Individual
Prefix:
First Name:LYNNETTE
Middle Name:
Last Name:MUNSELLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12340 DESERT PALMS AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-2293
Mailing Address - Country:US
Mailing Address - Phone:915-867-6466
Mailing Address - Fax:
Practice Address - Street 1:7400 HELEN OF TROY DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912
Practice Address - Country:US
Practice Address - Phone:915-742-7100
Practice Address - Fax:915-742-9542
Is Sole Proprietor?:No
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX733846163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management