Lynette Ann McMahon, R.N.

Individual provider Active NPI Registered Nurse · Menominee, MI

NPI 1356679708 · NPPES record last updated Nov 25, 2009

Key facts

NPI
1356679708
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
90687-030 (WI)
Practice address
1201 West Dr
Menominee, MI 49858-2327
Phone
(906) 863-8216
NPI assigned
Nov 23, 2009
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
90687-030WIMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 90687-030 WI Yes

Addresses

Primary practice location

1201 West Dr
Menominee, MI 49858-2327

Mailing address

1201 West Dr
Menominee, MI 49858-2327
Phone (906) 863-8216

Other providers in Menominee, MI

All providers in Menominee, MI · Registered Nurse in Michigan

Sources for this page

Verify at the official NPI Registry.