Provider Demographics
NPI:1619916020
Name:LYNES, JENNIFER S (DO)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:S
Last Name:LYNES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1723 MAHAN CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5428
Mailing Address - Country:US
Mailing Address - Phone:850-446-1077
Mailing Address - Fax:850-312-4352
Practice Address - Street 1:1723 MAHAN CENTER BLVD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5428
Practice Address - Country:US
Practice Address - Phone:850-446-1077
Practice Address - Fax:850-312-4352
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC200501199207Q00000X
FLOS11206207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine