Provider Demographics
NPI:1457163453
Name:MAINELLO, LINDSEY ANNE (CRNP)
Entity type:Individual
Prefix:MISS
First Name:LINDSEY
Middle Name:ANNE
Last Name:MAINELLO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:ANNE
Other - Last Name:REED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11688 STATION RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:16652-7615
Mailing Address - Country:US
Mailing Address - Phone:814-386-6076
Mailing Address - Fax:
Practice Address - Street 1:1120 PIKE ST
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:16652-1172
Practice Address - Country:US
Practice Address - Phone:814-643-6520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-25
Last Update Date:2025-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP031923363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner