Provider Demographics
NPI:1194704593
Name:BEACH, LYNN LASHAY (CAPT / MC / USN)
Entity type:Individual
Prefix:DR
First Name:LYNN
Middle Name:LASHAY
Last Name:BEACH
Suffix:
Gender:F
Credentials:CAPT / MC / USN
Other - Prefix:DR
Other - First Name:LYNN
Other - Middle Name:L
Other - Last Name:BEACH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:6000 W HIGHWAY 98
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32512-0001
Mailing Address - Country:US
Mailing Address - Phone:850-505-6253
Mailing Address - Fax:850-505-6259
Practice Address - Street 1:2080 CHILD ST
Practice Address - Street 2:NAVAL HOSPITAL JACKSONVILLE, ATTN: LABORATORY
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32214-5005
Practice Address - Country:US
Practice Address - Phone:904-542-7388
Practice Address - Fax:904-542-7399
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME142455171000000X
VA0101049638207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No171000000XOther Service ProvidersMilitary Health Care Provider