Provider Demographics
NPI:1144925652
Name:MARTIN-LYNCH, REGINA LYNN
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:LYNN
Last Name:MARTIN-LYNCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11501 PACEYS POND CIR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32222-4913
Mailing Address - Country:US
Mailing Address - Phone:954-857-1946
Mailing Address - Fax:904-619-6196
Practice Address - Street 1:11501 PACEYS POND CIR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32222-4913
Practice Address - Country:US
Practice Address - Phone:954-857-1946
Practice Address - Fax:904-619-6196
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion