Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 16260 | WV |
N | 207KA0200X | Allergist | 29316 | KY |
NPI | 1184734758 |
---|---|
Provider Name | Joan A Lynch |
First Address | Huntington, WV 25705-4130 |
Second Address | Huntington, WV 25703-2019 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 05/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0011693000 | (05) | WV |
0044083000 | (05) | WV |
16260 | LISENSE NUMBER (01) | WV |
29316 | LISENSE NUMBER (01) | KY |
64698772 | (05) | KY |
65930083 | (05) | KY |
BL3192236 | DEA (01) | WV |
F39127 | (02) | WV |
L0968403 | (05) | OH |
LO874442 | (05) | OH |