Provider Demographics
NPI:1144870460
Name:LYNCH, NICHOLE MARIE (MSN, APRN-CNP)
Entity type:Individual
Prefix:MRS
First Name:NICHOLE
Middle Name:MARIE
Last Name:LYNCH
Suffix:
Gender:F
Credentials:MSN, APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 N SUMMIT ST FL 7
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-2615
Mailing Address - Country:US
Mailing Address - Phone:800-427-1902
Mailing Address - Fax:419-531-2664
Practice Address - Street 1:10540 FREMONT PIKE
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-3356
Practice Address - Country:US
Practice Address - Phone:419-252-6018
Practice Address - Fax:419-531-2664
Is Sole Proprietor?:No
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.025392363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily