Provider Demographics
NPI:1528800018
Name:LYNCH, JENNIFER DENISE
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:DENISE
Last Name:LYNCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2041 ROPER SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:NC
Mailing Address - Zip Code:27850-8648
Mailing Address - Country:US
Mailing Address - Phone:252-532-0548
Mailing Address - Fax:
Practice Address - Street 1:2041 ROPER SPRINGS RD
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:NC
Practice Address - Zip Code:27850-8648
Practice Address - Country:US
Practice Address - Phone:252-532-0548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21983453343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)