Provider Demographics
NPI:1528429560
Name:LYN, CHRISELDA
Entity type:Individual
Prefix:MRS
First Name:CHRISELDA
Middle Name:
Last Name:LYN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:
Other - Last Name:LYN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:243 ABERNATHY CIR SE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32909-2346
Mailing Address - Country:US
Mailing Address - Phone:321-543-2989
Mailing Address - Fax:
Practice Address - Street 1:243 ABERNATHY CIR SE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32909-2346
Practice Address - Country:US
Practice Address - Phone:321-543-2989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-18
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula