Basic Information
Provider Information
NPI: 1992813315
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BILLETT
FirstName: LYNN
MiddleName: MEI
NamePrefix: MRS.
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: P.O BOX 2147
Address2:  
City: FORT MYERS
State: FL
PostalCode: 339022147
CountryCode: US
TelephoneNumber: 2394241449
FaxNumber: 2394241421
Practice Location
Address1: 5225 CLAYTON CRT
Address2:  
City: FORT MYERS
State: FL
PostalCode: 339072117
CountryCode: US
TelephoneNumber: 2399397222
FaxNumber: 2399391054
Other Information
ProviderEnumerationDate: 08/26/2006
LastUpdateDate: 04/17/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XNP 12000CAN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
363LF0000XARNP9323586FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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