Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 209016750 | IL |
N | 363LP2300X | Nurse Practitioner - Primary Care | 28127970A | IN |
NPI | 1093123234 |
---|---|
Provider Name | Lynne Marie Clapman |
First Address | Dyer, IN 46311-1365 |
Second Address | Chicago, IL 60647-5247 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2014 |
Last Update Date | 11/01/2022 |