Provider Demographics
NPI:1194544171
Name:SULLIVAN, LYNDSAY ANNE (DNP, APRN, FNP-C)
Entity type:Individual
Prefix:DR
First Name:LYNDSAY
Middle Name:ANNE
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:DR
Other - First Name:LYNDSAY
Other - Middle Name:ANNE
Other - Last Name:THOMASSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, APRN, FNP-C
Mailing Address - Street 1:308 PASEO DE LA PLAYA APT 8
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-6251
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:308 PASEO DE LA PLAYA APT 8
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-6251
Practice Address - Country:US
Practice Address - Phone:480-689-0756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95030446363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily