Provider Demographics
NPI:1194300442
Name:PIPITONE, LYNN MARIE (FNP)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:MARIE
Last Name:PIPITONE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2859 CALLE HERALDO
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92673-3572
Mailing Address - Country:US
Mailing Address - Phone:949-632-3605
Mailing Address - Fax:
Practice Address - Street 1:26932 OSO PKWY STE 270
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-5810
Practice Address - Country:US
Practice Address - Phone:949-600-5325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-17
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95016928363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily