Provider Demographics
NPI:1043325723
Name:KERNAN, LYNN (PT)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:KERNAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3125 BURLESON DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-8911
Mailing Address - Country:US
Mailing Address - Phone:972-509-7510
Mailing Address - Fax:
Practice Address - Street 1:1223 W MCDERMOTT DR
Practice Address - Street 2:SUITE 50
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-6412
Practice Address - Country:US
Practice Address - Phone:972-359-1288
Practice Address - Fax:972-359-9652
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1059004225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K3565Medicare PIN