Provider Demographics
NPI:1669043030
Name:LAMBERT, CASSILYN N (AGACNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:CASSILYN
Middle Name:N
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:MS
Other - First Name:CASSILYN
Other - Middle Name:N
Other - Last Name:LINXILER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AGACNP-BC
Mailing Address - Street 1:3800 VENETIAN WAY
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-8257
Mailing Address - Country:US
Mailing Address - Phone:812-266-2933
Mailing Address - Fax:812-469-3285
Practice Address - Street 1:3800 VENETIAN WAY
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630
Practice Address - Country:US
Practice Address - Phone:812-477-6103
Practice Address - Fax:812-477-4897
Is Sole Proprietor?:No
Enumeration Date:2021-07-07
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71011340A363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN71011340AOtherIN STATE LICENSE
IN71011340BOtherINDIANA CSR
000001573516OtherBCBS
KY7100757790Medicaid
IN300053253Medicaid
IN71011340AOtherIN STATE LICENSE