Provider Demographics
NPI:1407406234
Name:HUMMELL, LINDSAY (PA)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:HUMMELL
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 1:1645 CLEMENS RD
Mailing Address - Street 2:
Mailing Address - City:HARLEYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19438-2903
Mailing Address - Country:US
Mailing Address - Phone:267-421-8687
Mailing Address - Fax:
Practice Address - Street 1:1019 S BROAD ST
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-5338
Practice Address - Country:US
Practice Address - Phone:215-361-5090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-13
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA004996363AM0700X
NJ25MP00681300363A00000X
PAMA061026363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical