Provider Demographics
NPI:1043337736
Name:ZOLLIN, LYNN CAMERON (MFA, CSA, SA-C)
Entity type:Individual
Prefix:MS
First Name:LYNN
Middle Name:CAMERON
Last Name:ZOLLIN
Suffix:
Gender:F
Credentials:MFA, CSA, SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1521 PONTIAC ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-1827
Mailing Address - Country:US
Mailing Address - Phone:303-596-2449
Mailing Address - Fax:303-394-0854
Practice Address - Street 1:1521 PONTIAC ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-1827
Practice Address - Country:US
Practice Address - Phone:303-596-2449
Practice Address - Fax:303-394-0854
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCERT # F01172363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical