| Doctor Name: | MS. MISTI LYNN |
| NPI Number: | 1003238353 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP-C |
| License Number: | APN0000018106 |
| Business Practice Address: | 2450 S Telshor Blvd Clinic West Las Cruces, NM - 880115069 |
| Business Phone Number: | 5755325455 |
| Business Fax Number: | |
| Mailing Address: | Po Box 14232, LAS CRUCES |
| State: | NM |
| Postal Code: | 880134232 |
| Phone Number: | 5755325455 |
| Fax Number: | 5755325641 |
| NPI Enumeration Date: | 01/06/2014 |
| NPI Last Update Date: | 12/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | APN0000018106 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |