Provider Demographics
NPI:1215755384
Name:LYNN, KELSEY TAYLOR (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:TAYLOR
Last Name:LYNN
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 GRASMERE AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-6155
Mailing Address - Country:US
Mailing Address - Phone:860-650-3848
Mailing Address - Fax:
Practice Address - Street 1:340 GRASMERE AVE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-6155
Practice Address - Country:US
Practice Address - Phone:860-650-3848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-28
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61611112363LF0000X
CT12.014249363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily