Provider Demographics
NPI:1932792546
Name:LYNCH, DEANNE MARIE (RDN)
Entity type:Individual
Prefix:
First Name:DEANNE
Middle Name:MARIE
Last Name:LYNCH
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:DEANE
Other - Middle Name:MARIE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:G3200 BEECHER RD STE MBI
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3613
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:G3200 BEECHER RD STE MBI
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3613
Practice Address - Country:US
Practice Address - Phone:760-908-9015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-15
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered