Provider Demographics
NPI:1215158555
Name:SCHAEFER, LYNN S (APRN-BC)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:S
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:
Other - Last Name:RICH-SCHAEFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN,MSN, CNN, APRN-BC
Mailing Address - Street 1:174 KAYLA DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT ROYAL
Mailing Address - State:NJ
Mailing Address - Zip Code:08061-1049
Mailing Address - Country:US
Mailing Address - Phone:609-432-1908
Mailing Address - Fax:
Practice Address - Street 1:174 KAYLA DR
Practice Address - Street 2:
Practice Address - City:MOUNT ROYAL
Practice Address - State:NJ
Practice Address - Zip Code:08061-1049
Practice Address - Country:US
Practice Address - Phone:609-432-1908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00082100363L00000X, 363LA2200X
NJ26NR06222500363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0187178Medicaid
143356Medicare PIN
NJ143356AB5Medicare PIN