Provider Demographics
NPI:1427151216
Name:MCGRATH, LYNN (CRNP)
Entity type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:
Last Name:MCGRATH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5331 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509
Mailing Address - Country:US
Mailing Address - Phone:814-868-1062
Mailing Address - Fax:
Practice Address - Street 1:215 HOLLAND ST
Practice Address - Street 2:LAKE ERIE WOMENS CENTER
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507
Practice Address - Country:US
Practice Address - Phone:814-453-5058
Practice Address - Fax:814-452-4174
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP001584G363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
S49528Medicare UPIN
MC006521Medicare ID - Type Unspecified