Provider Demographics
NPI:1013990175
Name:ANGELONE, LYNDA A (CRNA)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:A
Last Name:ANGELONE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:LYNDA
Other - Middle Name:CATHERINE
Other - Last Name:WHITEHEAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:1004 SOUTH ROCK STREET
Mailing Address - Street 2:WESTLAKE ANESTHESIA GROUP, PA
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626
Mailing Address - Country:US
Mailing Address - Phone:512-279-0348
Mailing Address - Fax:512-371-8788
Practice Address - Street 1:5656 WEST BEE CAVES ROAD
Practice Address - Street 2:SUITE M-302
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-5236
Practice Address - Country:US
Practice Address - Phone:512-697-3502
Practice Address - Fax:512-697-3501
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70297367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
8Y1862OtherBLUE CROSS
TX166840201Medicaid
TX84187UOtherBC/BS
TX166840203Medicaid
TX166840203Medicaid
TX84187UOtherBC/BS
TXP00430224Medicare PIN
P00441155Medicare PIN
8J5067Medicare PIN
P00441155Medicare PIN