Provider Demographics
NPI:1669130258
Name:GATES, LYNDSEY (DNP, APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:LYNDSEY
Middle Name:
Last Name:GATES
Suffix:
Gender:F
Credentials:DNP, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 62
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:12095-0062
Mailing Address - Country:US
Mailing Address - Phone:518-284-0700
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 62
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:NY
Practice Address - Zip Code:12095-0062
Practice Address - Country:US
Practice Address - Phone:518-284-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-01
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY404030363LP0808X
VT101.0135143363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health