Provider Demographics
NPI:1194177477
Name:WARREN, LYNN (NPC)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:WARREN
Suffix:
Gender:F
Credentials:NPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 PHILADELPHIA DR
Mailing Address - Street 2:SUITE 441
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45406-1840
Mailing Address - Country:US
Mailing Address - Phone:937-734-4690
Mailing Address - Fax:937-734-4186
Practice Address - Street 1:2200 PHILADELPHIA DR
Practice Address - Street 2:SUITE 441
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406-1840
Practice Address - Country:US
Practice Address - Phone:937-734-4690
Practice Address - Fax:937-734-4186
Is Sole Proprietor?:No
Enumeration Date:2016-07-11
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.019509363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHAPRN.CNP.019509OtherOHIO BOARD OF NURSING