Provider Demographics
NPI:1851850499
Name:LYNCH, SHAUN PAUL (PHARMD)
Entity type:Individual
Prefix:
First Name:SHAUN
Middle Name:PAUL
Last Name:LYNCH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1439 BRUCE GAP RD
Mailing Address - Street 2:
Mailing Address - City:CARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37714-3832
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1439 BRUCE GAP RD
Practice Address - Street 2:
Practice Address - City:CARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37714-3832
Practice Address - Country:US
Practice Address - Phone:423-912-6210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-13
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN170358163W00000X
TN38287183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No163W00000XNursing Service ProvidersRegistered Nurse