Provider Demographics
NPI:1154436673
Name:LYNCH, ARLENE M (RN/PC)
Entity type:Individual
Prefix:
First Name:ARLENE
Middle Name:M
Last Name:LYNCH
Suffix:
Gender:F
Credentials:RN/PC
Other - Prefix:
Other - First Name:ARLENE
Other - Middle Name:M
Other - Last Name:DOLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN/PC
Mailing Address - Street 1:15 ROBIN RD
Mailing Address - Street 2:
Mailing Address - City:LYNNFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01940-2248
Mailing Address - Country:US
Mailing Address - Phone:781-945-0026
Mailing Address - Fax:
Practice Address - Street 1:151 MYSTIC AVE
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-4632
Practice Address - Country:US
Practice Address - Phone:781-396-1199
Practice Address - Fax:781-396-1439
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA114489364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANS0529Medicare ID - Type Unspecified