Provider Demographics
NPI:1770259699
Name:DAY, LYNDSAY MAY
Entity Type:Individual
Prefix:
First Name:LYNDSAY
Middle Name:MAY
Last Name:DAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LYNDSAY
Other - Middle Name:MAY
Other - Last Name:WEESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30 PINE GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:GLENBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04401-1455
Mailing Address - Country:US
Mailing Address - Phone:207-431-0072
Mailing Address - Fax:
Practice Address - Street 1:42 CEDAR ST
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6433
Practice Address - Country:US
Practice Address - Phone:207-947-0366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERN68021163W00000X
MECNP211165363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse