Provider Demographics
NPI:1134473697
Name:CLINGERSMITH, LYNDSEY JEANNE HELEN
Entity Type:Individual
Prefix:MISS
First Name:LYNDSEY
Middle Name:JEANNE HELEN
Last Name:CLINGERSMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1927 MARJORIE RD
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:14072-2615
Mailing Address - Country:US
Mailing Address - Phone:716-713-9003
Mailing Address - Fax:
Practice Address - Street 1:1927 MARJORIE RD
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NY
Practice Address - Zip Code:14072-2615
Practice Address - Country:US
Practice Address - Phone:716-713-9003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-06
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY650029-1163W00000X
NY6500029-1163WD1100X, 163WN0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WD1100XNursing Service ProvidersRegistered NurseDialysis, Peritoneal
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care