Provider Demographics
NPI:1730155888
Name:FAUST, LYNNE W (APRN BC)
Entity type:Individual
Prefix:
First Name:LYNNE
Middle Name:W
Last Name:FAUST
Suffix:
Gender:F
Credentials:APRN BC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:585 MERRIMACK ST
Mailing Address - Street 2:LOWELL COMMUNITY HEALTH CENTER
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854
Mailing Address - Country:US
Mailing Address - Phone:978-446-0236
Mailing Address - Fax:978-446-0248
Practice Address - Street 1:15 WARREN ST
Practice Address - Street 2:LOWELL COMMUNITY HEALTH CENTER
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01854
Practice Address - Country:US
Practice Address - Phone:978-446-0236
Practice Address - Fax:978-446-0248
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA141978363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP433801OtherMEDICARE PTAN
MANP4338Medicare ID - Type Unspecified
Q02712Medicare UPIN