Provider Demographics
NPI:1881918464
Name:BUSHEY, LINDSEY NICHOLS (PA-C)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:NICHOLS
Last Name:BUSHEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:AMANDA
Other - Last Name:NICHOLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2014 WASHINGTON ST
Mailing Address - Street 2:6 EAST PA OFFICE
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02462-1607
Mailing Address - Country:US
Mailing Address - Phone:617-219-1670
Mailing Address - Fax:617-219-1665
Practice Address - Street 1:2014 WASHINGTON ST
Practice Address - Street 2:6 EAST PA OFFICE
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462-1607
Practice Address - Country:US
Practice Address - Phone:617-219-1670
Practice Address - Fax:617-219-1665
Is Sole Proprietor?:No
Enumeration Date:2010-03-25
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA3957363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant