Provider Demographics
NPI:1376769810
Name:REIDLING, LYNDA (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:
Last Name:REIDLING
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 NE GOLDIE ST
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-4832
Mailing Address - Country:US
Mailing Address - Phone:360-240-4080
Mailing Address - Fax:360-240-4081
Practice Address - Street 1:1300 NE GOLDIE ST
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-4832
Practice Address - Country:US
Practice Address - Phone:360-240-4080
Practice Address - Fax:360-240-4081
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007756363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily