Provider Demographics
NPI:1639322498
Name:MCDONALD, LYNDEN E (LPN)
Entity Type:Individual
Prefix:MS
First Name:LYNDEN
Middle Name:E
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:LYNDEN
Other - Middle Name:
Other - Last Name:MCDONALD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:1105 TROUT DR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44903-8211
Mailing Address - Country:US
Mailing Address - Phone:419-610-6248
Mailing Address - Fax:
Practice Address - Street 1:1105 TROUT DR
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44903-8211
Practice Address - Country:US
Practice Address - Phone:149-610-6248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN081089164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse