Provider Demographics
NPI:1447611272
Name:SCALES, LYNDA (FNP)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:
Last Name:SCALES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:LYNDA
Other - Middle Name:
Other - Last Name:PANGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2730 FAUNA CT
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-8312
Mailing Address - Country:US
Mailing Address - Phone:209-725-0914
Mailing Address - Fax:
Practice Address - Street 1:3349 G ST
Practice Address - Street 2:STE F
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-0978
Practice Address - Country:US
Practice Address - Phone:209-349-8459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-07
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA383045163W00000X
CA95004563363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA383045OtherRN