Provider Demographics
NPI:1902119761
Name:LYNCH, JENNIFER M (ARNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:LYNCH
Suffix:
Gender:F
Credentials:ARNP
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Mailing Address - Street 1:PO BOX 191
Mailing Address - Street 2:PROVIDER ENROLLMENT DEPARTMENT
Mailing Address - City:ROCKLAND
Mailing Address - State:DE
Mailing Address - Zip Code:19732-0191
Mailing Address - Country:US
Mailing Address - Phone:302-651-4488
Mailing Address - Fax:302-651-4945
Practice Address - Street 1:11715 ORPINGTON ST STE A
Practice Address - Street 2:TLC PEDIATRICS AND ASOLESCENT MEDICINE IN ASOOC WITH NE
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-4600
Practice Address - Country:US
Practice Address - Phone:407-380-9115
Practice Address - Fax:407-380-9189
Is Sole Proprietor?:No
Enumeration Date:2010-07-22
Last Update Date:2012-12-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP 9247695363LP0200X
FLARNP9247695363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics