Provider Demographics
NPI:1396901013
Name:VARGO, LYN EVE (PHD, RN, NNP-BC10/22)
Entity type:Individual
Prefix:DR
First Name:LYN
Middle Name:EVE
Last Name:VARGO
Suffix:
Gender:F
Credentials:PHD, RN, NNP-BC10/22
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:31 OAK BLUFF DR
Mailing Address - Street 2:
Mailing Address - City:LAKE SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63367-1801
Mailing Address - Country:US
Mailing Address - Phone:636-887-2020
Mailing Address - Fax:636-887-2051
Practice Address - Street 1:621 S NEW BALLAS RD
Practice Address - Street 2:SUITE 2016
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8232
Practice Address - Country:US
Practice Address - Phone:314-251-5860
Practice Address - Fax:314-251-5861
Is Sole Proprietor?:No
Enumeration Date:2008-08-01
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO064708163WN0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care