Mary Lynn Booker, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024138177 Issued in VA

Practice address

11814 King William Rd
Aylett, VA 23009-4103

Phone

(804) 769-3022

Fax

(804) 769-1253

NPI assigned

Jan 6, 2006

Last updated

Oct 14, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413244800000",
    "number": "1972581262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11814 KING WILLIAM RD",
            "address_2": "PO BOX 213",
            "city": "AYLETT",
            "state": "VA",
            "postal_code": "230094103",
            "telephone_number": "804-769-3022",
            "fax_number": "804-769-1253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11814 KING WILLIAM RD",
            "city": "AYLETT",
            "state": "VA",
            "postal_code": "230094103",
            "telephone_number": "804-769-3022",
            "fax_number": "804-769-1253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOKER",
        "first_name": "MARY LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-06",
        "last_updated": "2014-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024138177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jonathan W Biggers III, D.O.
• Blessed by Grace, LLC
• Rachael Nicole Bowling, LDO
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• Latricia Broaddus
• Lily Alemi Cameron, MD
• Central Virginia Health Services Inc (CVHS King William)

• Family Nurse Practitioner in Aylett, VA
• Providers in Aylett, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.