Provider Demographics
NPI:1710472121
Name:MCDONALD, LYNDA NICOLE (FNP-C)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:NICOLE
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9119 MIL PARK AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LEWIS
Mailing Address - State:WA
Mailing Address - Zip Code:98433
Mailing Address - Country:US
Mailing Address - Phone:253-477-0821
Mailing Address - Fax:253-477-0818
Practice Address - Street 1:9040 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-4013
Practice Address - Country:US
Practice Address - Phone:253-477-0821
Practice Address - Fax:253-477-0818
Is Sole Proprietor?:No
Enumeration Date:2018-06-27
Last Update Date:2021-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60300522163W00000X
TX912797163W00000X
TXAP137840363LF0000X
WAAP61044092363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse