Provider Demographics
NPI:1144767120
Name:YUNG, LYNNE SPENCER (RN)
Entity type:Individual
Prefix:
First Name:LYNNE
Middle Name:SPENCER
Last Name:YUNG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5609 EAST LN
Mailing Address - Street 2:
Mailing Address - City:LAKE VIEW
Mailing Address - State:NY
Mailing Address - Zip Code:14085-9629
Mailing Address - Country:US
Mailing Address - Phone:716-515-5920
Mailing Address - Fax:
Practice Address - Street 1:5609 EAST LN
Practice Address - Street 2:
Practice Address - City:LAKE VIEW
Practice Address - State:NY
Practice Address - Zip Code:14085-9629
Practice Address - Country:US
Practice Address - Phone:716-515-5920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-27
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY467642163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse