Provider Demographics
NPI:1285725663
Name:LYNN, MARIE E (RN, CCM)
Entity type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:E
Last Name:LYNN
Suffix:
Gender:F
Credentials:RN, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2608 EASY ST
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020-7122
Mailing Address - Country:US
Mailing Address - Phone:903-337-0418
Mailing Address - Fax:
Practice Address - Street 1:1111 GALLAGHER DR
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-1713
Practice Address - Country:US
Practice Address - Phone:903-870-7483
Practice Address - Fax:903-870-7162
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX226892163WC0400X
TX00032168163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management