LYNNETTE K PROKOP PA NPI 1205292497

NPI Information

  • NPI: 1205292497
  • Provider Name: LYNNETTE K PROKOP, PA
  • Classification: Physician Assistant - 363AS0400X
  • Specialization: Surgical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1325 EASTMORELAND AVE STE 310
    MEMPHIS, TN
    ZIP 38104
  • Phone: (901) 758-7970

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NPI Details

Lynnette K Prokop, PA is a surgical physician assistant in Memphis, TN with 10 years of experience. Lynnette K Prokop, PA NPI is 1205292497. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1325 EASTMORELAND AVE STE 310
MEMPHIS, TN
ZIP 38104-544
Phone: (901) 758-7970
Fax: (901) 266-6425

The NPI 1205292497 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/5/2016 and was last updated on 4/5/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363A00000XPhysician Assistant50.004572RXOHIONo
2363AS0400XPhysician AssistantSurgical4968TENNESSEEYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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