Provider Demographics
NPI:1871900225
Name:JAMES, LYNLEY R (NP-C)
Entity type:Individual
Prefix:
First Name:LYNLEY
Middle Name:R
Last Name:JAMES
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:LYNLEY
Other - Middle Name:R
Other - Last Name:AMBROSON/KNIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:2315 8TH ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ID
Mailing Address - Zip Code:83501-7301
Mailing Address - Country:US
Mailing Address - Phone:208-746-1383
Mailing Address - Fax:208-746-6348
Practice Address - Street 1:2500 W A ST STE 101
Practice Address - Street 2:
Practice Address - City:MOSCOW
Practice Address - State:ID
Practice Address - Zip Code:83843-6000
Practice Address - Country:US
Practice Address - Phone:208-882-0540
Practice Address - Fax:208-883-1853
Is Sole Proprietor?:No
Enumeration Date:2014-07-17
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60480678363LF0000X
IDNP-1431A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1871900225OtherFCHN
ID1871900225OtherBLUE CROSS OF IDAHO
WA1871900225OtherMOLINA HEALTHCARE OF WA
ID1871900225Medicaid
ID1871900225OtherREGENCE BLUE SHIELD
ID1871900225OtherIPN
WA1871900225Medicaid
ID1871900225OtherREGENCE BLUE SHIELD
ID1871900225Medicaid