Provider Demographics
NPI:1255686416
Name:DAVEL, LINDSAY W (DNP, APNP)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:W
Last Name:DAVEL
Suffix:
Gender:F
Credentials:DNP, APNP
Other - Prefix:MISS
Other - First Name:LINDSAY
Other - Middle Name:
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:700 N WESTHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54904-6947
Mailing Address - Country:US
Mailing Address - Phone:920-456-2030
Mailing Address - Fax:920-456-2025
Practice Address - Street 1:700 N WESTHAVEN DR
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54904
Practice Address - Country:US
Practice Address - Phone:920-456-2030
Practice Address - Fax:920-456-2025
Is Sole Proprietor?:No
Enumeration Date:2012-07-13
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4951363L00000X
WI4951-33363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100025957Medicaid
WI100036836Medicaid