Provider Demographics
NPI:1265328843
Name:NEATHERLIN, LYNN DENISE (RN)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:DENISE
Last Name:NEATHERLIN
Suffix:
Gender:X
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 SE 9TH ST
Mailing Address - Street 2:
Mailing Address - City:PRYOR
Mailing Address - State:OK
Mailing Address - Zip Code:74361-7023
Mailing Address - Country:US
Mailing Address - Phone:918-530-8274
Mailing Address - Fax:
Practice Address - Street 1:708 SE 9TH ST
Practice Address - Street 2:
Practice Address - City:PRYOR
Practice Address - State:OK
Practice Address - Zip Code:74361-7023
Practice Address - Country:US
Practice Address - Phone:918-530-8274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0055949163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine