Provider Demographics
NPI:1730225780
Name:PATTY, LYNN CAROL (NP)
Entity type:Individual
Prefix:MS
First Name:LYNN
Middle Name:CAROL
Last Name:PATTY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6042 N FRESNO ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5279
Mailing Address - Country:US
Mailing Address - Phone:559-224-6754
Mailing Address - Fax:
Practice Address - Street 1:6042 N FRESNO ST
Practice Address - Street 2:STE 101
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5279
Practice Address - Country:US
Practice Address - Phone:559-224-6754
Practice Address - Fax:559-490-1376
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA358513363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner