Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | API142507 | TX |
N | 363LG0600X | Nurse Practitioner - Gerontology | API142507 | TX |
NPI | 1073167615 |
---|---|
Provider Name | Mrs. Lynn Kimmel |
First Address | El Paso, TX 79912-3732 |
Second Address | El Paso, TX 79902-1124 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2019 |
Last Update Date | 27/10/2021 |