Provider Demographics
NPI:1447536867
Name:ALEXANDER, LYNN C (RN)
Entity type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:C
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 VANDERBILT AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-1819
Mailing Address - Country:US
Mailing Address - Phone:716-807-3700
Mailing Address - Fax:
Practice Address - Street 1:1500 VANDERBILT AVE
Practice Address - Street 2:
Practice Address - City:NORTH TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120-1819
Practice Address - Country:US
Practice Address - Phone:716-807-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4765000163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01377162Medicaid