Provider Demographics
NPI:1861890030
Name:LAKIN, LYNSEY LOUISE (FNP-C)
Entity type:Individual
Prefix:MS
First Name:LYNSEY
Middle Name:LOUISE
Last Name:LAKIN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:LYNSEY
Other - Middle Name:
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12822 SEAHORSE DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91739
Mailing Address - Country:US
Mailing Address - Phone:909-921-1823
Mailing Address - Fax:909-946-9931
Practice Address - Street 1:1015 N 1ST AVE APT A
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-7401
Practice Address - Country:US
Practice Address - Phone:626-598-3770
Practice Address - Fax:909-946-9931
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-19
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COF0813038363LF0000X
CA23845363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily