Provider Demographics
NPI:1144294067
Name:NAUMAN, LYNN ELIZABETH (MD)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:ELIZABETH
Last Name:NAUMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 W ALAMEDA ST APT A6
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-9655
Mailing Address - Country:US
Mailing Address - Phone:970-903-6026
Mailing Address - Fax:
Practice Address - Street 1:2300 W ALAMEDA ST APT A6
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-9655
Practice Address - Country:US
Practice Address - Phone:970-903-6026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO46495207P00000X
NMMD2004-0488207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM80824234Medicaid
CO94882878Medicaid
NYJ400004824Medicare PIN
NYJ400004825Medicare PIN
CO300244Medicare PIN
NMI23993Medicare UPIN
NM348534013Medicare ID - Type Unspecified