Provider Demographics
NPI:1912707712
Name:MARTIN, LINDSEY M (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:M
Last Name:MARTIN
Suffix:
Gender:
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 E SWANSON AVE STE 27
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-7056
Mailing Address - Country:US
Mailing Address - Phone:907-531-7306
Mailing Address - Fax:
Practice Address - Street 1:231 E SWANSON AVE STE 27
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7056
Practice Address - Country:US
Practice Address - Phone:907-531-7306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK232481363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health