LYNN M MORENO (NPI# 1992047443) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992047443 |
| Entity Type | Individual |
| Full Name | LYNN M MORENO |
| Other Name | LYNN M LAKOMA |
| Credential | PA-C |
| Practice Address |
2790 Godwin Blvd Ste 100 Suffolk VA 23434-8151 |
| Practice Telephone | 7579838750 |
| Practice Fax Number | 7575109442 |
| Mailing Telephone | 7579838750 |
| Mailing Fax Number | 7575109442 |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2019-03-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
085004597 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
085004597 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2790 GODWIN BLVD STE 100 |
| City | SUFFOLK |
| State | VA |
| Zip Code | 23434-8151 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386607653 | Edward Michael Lynch | Internal Medicine | 2790 Godwin Blvd Ste 100, Suffolk, VA 23434-8151 | 2006-04-08 |
| 1699268490 | Rachel Devon Tobias | Physician Assistant | 2790 Godwin Blvd Ste 100, Suffolk, VA 23434-8151 | 2018-06-07 |
| 1447510763 | Sentara Medical Group | Internal Medicine | 2790 Godwin Blvd Ste 100, Suffolk, VA 23434-8151 | 2012-05-21 |
| 1548526080 | Sonia Samtani | Internal Medicine | 2790 Godwin Blvd Ste 100, Suffolk, VA 23434-8151 | 2012-04-10 |
| 1316153737 | Christina A Mcdowell | Internal Medicine | 2790 Godwin Blvd Ste 100, Suffolk, VA 23434-8151 | 2007-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235780255 | Chiquita Savage | Home Health | You 1st Healthcare, 112 West Washington Street Suite 502, Suffolk, VA 23434 | 2019-09-20 |
| 1912561713 | Revivication Counseling Services | Counselor | 814 Cripple Creek Lane, Suffolk, VA 23434 | 2019-04-26 |
| 1558826958 | Nita Jenkins | Non-emergency Medical Transport (VAN) | 707 Gittings St. Suite 105, Suffolk, VA 23434 | 2019-02-10 |
| 1730660952 | Latrese L Riddick | Driver | 418 Jackson St, Suffolk, VA 23434 | 2018-08-25 |
| 1114411279 | Percilla D Zeno | Community Health Worker | 102 Niblick Cir, Suffolk, VA 23434 | 2018-06-21 |
| 1437652765 | Aprele Gaddie | Health Educator | 2769 Godwin Boulevard, Suffolk, VA 23434 | 2018-03-13 |
| 1598284283 | Domonic Teheran Scott | Driver | 102 Brewer Ave, Suffolk, VA 23434 | 2017-09-13 |
| 1578089397 | Nakia Shantel Francis | Nurse Practitioner | 2970 Godwin Blvd, Suite 320, Suffolk, VA 23434 | 2017-08-15 |
| 1679093009 | Daisy Mae Aba, LLC | Behavioral Analyst | 3212 Clearcreek Rd., Suffolk, VA 23434 | 2017-06-27 |
| 1114457736 | Better Care Family Homes | Day Training, Developmentally Disabled Services | 813 West Washington Street, Suffolk, VA 23434 | 2017-06-15 |
| Find all providers in zip 23434 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538379276 | Rolando Mata | Physician Assistant | 4007 Brookline Dr, Suffolk, VA 23434-9327 | 2007-05-23 |
| 1588728307 | John David Spring | Physician Assistant | 209 Magnolia St, Suffolk, VA 23434-2234 | 2006-12-20 |
| 1861872640 | Jennifer Danelle Andrews | Physician Assistant | 5839 Harbour View Blvd Ste 200, Suffolk, VA 23435-3797 | 2015-06-05 |
| 1861722852 | Kelli Charlene Brezovic | Physician Assistant | 2470 Pruden Blvd, Suffolk, VA 23434-4206 | 2010-01-13 |
| 1023249976 | Lindsey M Williams | Physician Assistant | 2050 Hillpoint Blvd N, Suffolk, VA 23434-7181 | 2009-07-27 |
| 1497994578 | Latoya Denise Pumphrey | Physician Assistant | 1035 Champions Way, Suite 600, Suffolk, VA 23435-3762 | 2009-02-12 |
| 1982674487 | Michael Alexander Mitchell | Physician Assistant | 150 Burnetts Way, Ste. 100, Suffolk, VA 23434-8168 | 2006-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124638986 | Courtney Anne Kassner | Physician Assistant | 2706 Davis Ave, Alexandria, VA 22302-2817 | 2020-08-06 |
| 1295356145 | Nilofar Ariasaif | Physician Assistant | 15401 Bald Eagle Ln, Woodbridge, VA 22191-3782 | 2020-05-01 |
| 1396366555 | Sheelon Aghili | Physician Assistant | 5801 Hampton Forest Way, Fairfax, VA 22030-7254 | 2020-04-29 |
| 1679102347 | Mary Herrera | Physician Assistant | 6353 Center Dr Ste 204, Norfolk, VA 23502-0001 | 2020-04-05 |
| 1720614019 | Andrew James Meyers | Physician Assistant | 229 W Bute St Apt 207, Norfolk, VA 23510-1415 | 2020-03-18 |
| 1902432644 | Madison Alexis Cooper | Physician Assistant | 920 Battlefield Blvd S Ste 101, Chesapeake, VA 23322-4254 | 2020-03-13 |
| 1285296111 | Kimberly Stewart Hugo | Physician Assistant | 10932 Point Grey Road, Henrico, VA 23233-2429 | 2019-07-01 |
| 1558824698 | Jessica Leigh Pacuch | Physician Assistant | 2440 Raphine Rd, Raphine, VA 24472-2541 | 2019-04-06 |
| 1073074431 | Nicholas Alexander Jones | Physician Assistant | 924 Parley Pl, Chesapeake, VA 23323-4135 | 2019-03-28 |
| 1003371410 | Ryan Timothy Pyles | Physician Assistant | 25 Commerce Park Drive, Raphine, VA 24472 | 2019-02-11 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on LYNN M MORENO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.