Provider Demographics
NPI:1871172387
Name:PATZELT, LYNNE MARIE (NBC-HWC)
Entity type:Individual
Prefix:MRS
First Name:LYNNE
Middle Name:MARIE
Last Name:PATZELT
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 FENWAY CT
Mailing Address - Street 2:
Mailing Address - City:LAKEWAY
Mailing Address - State:TX
Mailing Address - Zip Code:78734-4541
Mailing Address - Country:US
Mailing Address - Phone:612-812-4123
Mailing Address - Fax:
Practice Address - Street 1:106 FENWAY CT
Practice Address - Street 2:
Practice Address - City:LAKEWAY
Practice Address - State:TX
Practice Address - Zip Code:78734-4541
Practice Address - Country:US
Practice Address - Phone:612-812-4123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-03
Last Update Date:2021-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date: