Basic Information
| Provider Information | |||||||||
| NPI: | 1043325723 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KERNAN | ||||||||
| FirstName: | LYNN | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3125 BURLESON DR | ||||||||
| Address2: | |||||||||
| City: | PLANO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750748911 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9725097510 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1223 W MCDERMOTT DR | ||||||||
| Address2: | SUITE 50 | ||||||||
| City: | ALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750136412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9723591288 | ||||||||
| FaxNumber: | 9723599652 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/20/2006 | ||||||||
| LastUpdateDate: | 09/12/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 1059004 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.