Provider Demographics
NPI:1992549612
Name:JEAN-LOUIS, LYNE R (DNP, WHNP-BC)
Entity type:Individual
Prefix:
First Name:LYNE
Middle Name:R
Last Name:JEAN-LOUIS
Suffix:
Gender:F
Credentials:DNP, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1277 E 14TH ST APT 303C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-5262
Mailing Address - Country:US
Mailing Address - Phone:917-972-5878
Mailing Address - Fax:
Practice Address - Street 1:1277 E 14TH ST APT 303C
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-5262
Practice Address - Country:US
Practice Address - Phone:917-972-5878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1686272363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health