Provider Demographics
NPI:1386603207
Name:CARRENS, LYNNETTE JEWEL (WHNP)
Entity type:Individual
Prefix:MRS
First Name:LYNNETTE
Middle Name:JEWEL
Last Name:CARRENS
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 N TOM GREEN AVE
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79761-5145
Mailing Address - Country:US
Mailing Address - Phone:432-580-9876
Mailing Address - Fax:432-580-9877
Practice Address - Street 1:405 N TOM GREEN AVE
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-5145
Practice Address - Country:US
Practice Address - Phone:432-580-9876
Practice Address - Fax:432-580-9877
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363LX0001X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Not Answered363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMR56311OtherCERTIFIED NURSE PRACTITIO
TX1434540Medicaid
TXP26044Medicare UPIN
TX8C8803Medicare ID - Type Unspecified