Provider Demographics
NPI:1285868539
Name:FITZGIBBONS, LYNN NISBET (MD)
Entity type:Individual
Prefix:DR
First Name:LYNN
Middle Name:NISBET
Last Name:FITZGIBBONS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LYNN
Other - Middle Name:MERI
Other - Last Name:NISBET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 50706
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93150-0706
Mailing Address - Country:US
Mailing Address - Phone:805-963-3757
Mailing Address - Fax:805-564-3332
Practice Address - Street 1:400 W PUEBLO ST RM 3635
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105
Practice Address - Country:US
Practice Address - Phone:805-569-7315
Practice Address - Fax:805-569-8358
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-14
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA99152207R00000X
ORMD150725207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine