Provider Demographics
NPI:1255655916
Name:BULGER, LYNDSAY ALLISON (CRNA, RN)
Entity Type:Individual
Prefix:
First Name:LYNDSAY
Middle Name:ALLISON
Last Name:BULGER
Suffix:
Gender:F
Credentials:CRNA, RN
Other - Prefix:
Other - First Name:LYNDSAY
Other - Middle Name:ALLISON
Other - Last Name:BIKUL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA, RN
Mailing Address - Street 1:22 INDIAN PIPE
Mailing Address - Street 2:
Mailing Address - City:DOVE CANYON
Mailing Address - State:CA
Mailing Address - Zip Code:92679-4206
Mailing Address - Country:US
Mailing Address - Phone:310-279-3664
Mailing Address - Fax:
Practice Address - Street 1:15 GLEN ECHO
Practice Address - Street 2:
Practice Address - City:DOVE CANYON
Practice Address - State:CA
Practice Address - Zip Code:92679
Practice Address - Country:US
Practice Address - Phone:310-279-3664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-23
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA664191163W00000X
CA3990367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse