Provider Demographics
NPI:1861062473
Name:MARA, LINDSEY (DNP)
Entity type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:
Last Name:MARA
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 HERON DR STE 108
Mailing Address - Street 2:
Mailing Address - City:SWEDESBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08085-1767
Mailing Address - Country:US
Mailing Address - Phone:856-467-8550
Mailing Address - Fax:856-467-3361
Practice Address - Street 1:510 HERON DR STE 108
Practice Address - Street 2:
Practice Address - City:SWEDESBORO
Practice Address - State:NJ
Practice Address - Zip Code:08085-1767
Practice Address - Country:US
Practice Address - Phone:856-467-8550
Practice Address - Fax:856-467-3361
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-26
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR22594800163W00000X
PASP023929363L00000X
NJ26NJ01173300363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner