Provider Demographics
NPI:1336435437
Name:PARADIS, LINDSAY (PA-C)
Entity Type:Individual
Prefix:MS
First Name:LINDSAY
Middle Name:
Last Name:PARADIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 ACCESS HWY
Mailing Address - Street 2:PO BOX 40
Mailing Address - City:CARIBOU
Mailing Address - State:ME
Mailing Address - Zip Code:04736-3807
Mailing Address - Country:US
Mailing Address - Phone:207-498-2356
Mailing Address - Fax:
Practice Address - Street 1:74 ACCESS HWY
Practice Address - Street 2:
Practice Address - City:CARIBOU
Practice Address - State:ME
Practice Address - Zip Code:04736-3807
Practice Address - Country:US
Practice Address - Phone:207-498-2356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-27
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AM0700X
MEPA1278363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME002351301OtherPTAN
ME01-0376890OtherPINES HEALTH SERVICES