Provider Demographics
NPI:1902084676
Name:MCHUGH, LYNN GROSE (FNP)
Entity type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:GROSE
Last Name:MCHUGH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:BARBARA
Other - Middle Name:LYNN
Other - Last Name:GROSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:122 W 7TH AVE
Mailing Address - Street 2:450
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2349
Mailing Address - Country:US
Mailing Address - Phone:509-455-8820
Mailing Address - Fax:509-838-4978
Practice Address - Street 1:122 W 7TH AVE
Practice Address - Street 2:450
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2349
Practice Address - Country:US
Practice Address - Phone:509-455-8820
Practice Address - Fax:509-838-4978
Is Sole Proprietor?:No
Enumeration Date:2008-02-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30004000363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID808169100Medicaid
WA9658287Medicaid
239818Medicare UPIN
WA9658287Medicaid