Provider Demographics
NPI:1215174313
Name:LYNCH, SANDRA JAYNE (RN, MSN, ANP, DHA,)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:JAYNE
Last Name:LYNCH
Suffix:
Gender:F
Credentials:RN, MSN, ANP, DHA,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7316 DESIERTO RICO AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-1146
Mailing Address - Country:US
Mailing Address - Phone:915-494-0642
Mailing Address - Fax:
Practice Address - Street 1:7102 WESTWIND DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-1726
Practice Address - Country:US
Practice Address - Phone:915-581-5100
Practice Address - Fax:915-581-6100
Is Sole Proprietor?:No
Enumeration Date:2009-01-12
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX587679367A00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife