Basic Information
Provider Information
NPI: 1558740480
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARRIS
FirstName: LYNN
MiddleName: TRAN
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 271647
Address2:  
City: SALT LAKE CITY
State: UT
PostalCode: 841271647
CountryCode: US
TelephoneNumber: 9199665136
FaxNumber: 9849744873
Practice Location
Address1: DEPARTMENT OF ANESTHESIOLOGY
Address2: N2198 UNC HOSPITALS CB# 7010
City: CHAPEL HILL
State: NC
PostalCode: 275997010
CountryCode: US
TelephoneNumber: 9199665136
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/26/2015
LastUpdateDate: 02/22/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X232525NCY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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