Provider Demographics
NPI:1861041071
Name:CANWELL, LYNDSAY (RN)
Entity Type:Individual
Prefix:
First Name:LYNDSAY
Middle Name:
Last Name:CANWELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 CAMBRIDGEPARK DR UNIT 344
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-2465
Mailing Address - Country:US
Mailing Address - Phone:207-441-8900
Mailing Address - Fax:
Practice Address - Street 1:160 CAMBRIDGEPARK DR UNIT 344
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02140-2465
Practice Address - Country:US
Practice Address - Phone:207-441-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-10
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2320142163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse