Provider Demographics
NPI:1598002347
Name:LYNN, LINDY LEE (CNM)
Entity type:Individual
Prefix:
First Name:LINDY
Middle Name:LEE
Last Name:LYNN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:LINDY
Other - Middle Name:LEE
Other - Last Name:MASON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:700 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TN
Mailing Address - Zip Code:38570-1720
Mailing Address - Country:US
Mailing Address - Phone:931-823-9970
Mailing Address - Fax:
Practice Address - Street 1:700 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TN
Practice Address - Zip Code:38570-1720
Practice Address - Country:US
Practice Address - Phone:931-823-9970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-14
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17285367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ000137Medicaid
TNQ000137Medicaid