Provider Demographics
NPI:1700568953
Name:ALVUT, LYNDSEY MARIE (AGPCNP)
Entity Type:Individual
Prefix:
First Name:LYNDSEY
Middle Name:MARIE
Last Name:ALVUT
Suffix:
Gender:F
Credentials:AGPCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2629 OCEAN FRONT WALK
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-8242
Mailing Address - Country:US
Mailing Address - Phone:585-301-5800
Mailing Address - Fax:
Practice Address - Street 1:2629 OCEAN FRONT WALK
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-8242
Practice Address - Country:US
Practice Address - Phone:585-301-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95022165363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care