Provider Demographics
NPI:1902511496
Name:LYNAM, MONICA LYNN (APRN-C)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:LYNN
Last Name:LYNAM
Suffix:
Gender:F
Credentials:APRN-C
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:LYNN
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:942 SAFE SAPPHIRE WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89178-2437
Mailing Address - Country:US
Mailing Address - Phone:630-338-6584
Mailing Address - Fax:
Practice Address - Street 1:6088 S DURANGO DR STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-1780
Practice Address - Country:US
Practice Address - Phone:702-380-4141
Practice Address - Fax:702-380-4242
Is Sole Proprietor?:No
Enumeration Date:2023-01-18
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV863502363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health