Provider Demographics
NPI:1497735955
Name:VANDERLINDE, SKY (FNP)
Entity Type:Individual
Prefix:MS
First Name:SKY
Middle Name:
Last Name:VANDERLINDE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WASON AVE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1381
Mailing Address - Country:US
Mailing Address - Phone:413-788-6139
Mailing Address - Fax:413-737-1549
Practice Address - Street 1:100 WASON AVE
Practice Address - Street 2:SUITE 230
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1381
Practice Address - Country:US
Practice Address - Phone:413-788-6139
Practice Address - Fax:413-737-1549
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA200367363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NP1578OtherBLUE CROSS BLUE SHIELD
VANP1578Medicare ID - Type Unspecified