Provider Demographics
NPI:1407487333
Name:CALDWELL, LYNNE (RN, PNP)
Entity Type:Individual
Prefix:
First Name:LYNNE
Middle Name:
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:RN, PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 NORWOOD ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-2639
Mailing Address - Country:US
Mailing Address - Phone:781-729-9566
Mailing Address - Fax:
Practice Address - Street 1:11 NORWOOD ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-2639
Practice Address - Country:US
Practice Address - Phone:781-729-9566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN224693363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics