Provider Demographics
NPI:1235473562
Name:ACKLEY, LINDSEY B (PA)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:B
Last Name:ACKLEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:AUDUBON
Mailing Address - State:NJ
Mailing Address - Zip Code:08106-2136
Mailing Address - Country:US
Mailing Address - Phone:609-760-5344
Mailing Address - Fax:
Practice Address - Street 1:409 WALNUT ST
Practice Address - Street 2:
Practice Address - City:AUDUBON
Practice Address - State:NJ
Practice Address - Zip Code:08106-2136
Practice Address - Country:US
Practice Address - Phone:609-760-5344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-27
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant