LYNDA G CARLYLE FNP NPI 1831412147

Nurse Practitioner (Family) in Odessa, MO

About LYNDA CARLYLE

Lynda Carlyle is a provider in Odessa, MO with more than 9 years of experience. The NPI number assigned to this provider is 1831412147. The practitioner's primary taxonomy code is Nurse Practitioner (363LF0000X). The provider is registered as an individual and their NPI record was last updated 7 years ago. Lynda Carlyle is registered with Medicare and accepts claims assignment.

NPI

1831412147

Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Name LYNDA G CARLYLE FNP
Provider Location Address1280 W US HIGHWAY 40 ODESSA, MO 64076 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address1280 W US HIGHWAY 40 ODESSA, MO 64076 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
GenderFemale
NPI Entity TypeIndividual Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Medical School NameOTHER
Graduation Year2009
Is Sole Proprietor?No
Is Organization Subpart?N/A Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Enumeration Date03-02-2010 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date09-08-2011 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

LYNDA G CARLYLE FNP
1280 W US HIGHWAY 40
ODESSA, MO
ZIP 64076
Phone: (816) 633-5774
Fax: (816) 633-5936

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Mailing Address

LYNDA G CARLYLE FNP
1280 W US HIGHWAY 40
ODESSA, MO
ZIP 64076
Phone: (816) 633-5774
Fax: (816) 633-5936

Primary Taxonomy

Taxonomy Code363LF0000X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationNurse Practitioner
TypePhysician Assistants & Advanced Practice Nursing Providers
SpecializationFamily
License No.2010005627
License StateMO

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
595985805MEDICAID (05)MO
595956103MEDICAID (05)MO
261320MEDICARE OSCAR/CERTIFICATION (06)
1831412147MEDICAID (05)MO
268550MEDICARE OSCAR/CERTIFICATION (06)
540568508MEDICAID (05)MO
268548MEDICARE OSCAR/CERTIFICATION (06)
P270000MEDICARE PIN (08)
43747016OTHER (01)
P27000020MEDICARE PIN (08)
43747026OTHER (01)

Other Providers at the same location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1003872185MIDWEST DIVISION-LRHC, LLC
Organization
Clinic/Center (Rural Health)1280 W US HIGHWAY 40
ODESSA, MO 64076
(816) 633-5774
1831154210DR. AHMAD W ASLAMI D.O.
Individual
Family Medicine1280 W US HIGHWAY 40
ODESSA, MO 64076
(816) 633-5774
Previous NPI
1831412139
Next NPI
1831412154