Provider Demographics
NPI:1760087548
Name:REDD, LINDSEY ANDRE (LPN)
Entity Type:Individual
Prefix:MR
First Name:LINDSEY
Middle Name:ANDRE
Last Name:REDD
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 KOSSUTH ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1338
Mailing Address - Country:US
Mailing Address - Phone:475-202-0211
Mailing Address - Fax:
Practice Address - Street 1:36 KOSSUTH ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1338
Practice Address - Country:US
Practice Address - Phone:475-202-0211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT39782164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse