Provider Demographics
NPI:1952407744
Name:CAPPELLUCCI, LYNNE MARIE (APRN)
Entity type:Individual
Prefix:
First Name:LYNNE
Middle Name:MARIE
Last Name:CAPPELLUCCI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:LYNNE
Other - Middle Name:MARIE
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PMHNP-BC, FNP-C
Mailing Address - Street 1:1696 US HIGHWAY 96
Mailing Address - Street 2:
Mailing Address - City:FOWLER
Mailing Address - State:CO
Mailing Address - Zip Code:81039-9761
Mailing Address - Country:US
Mailing Address - Phone:602-525-5130
Mailing Address - Fax:
Practice Address - Street 1:11 DOG HILL RD
Practice Address - Street 2:
Practice Address - City:DAYVILLE
Practice Address - State:CT
Practice Address - Zip Code:06241-2106
Practice Address - Country:US
Practice Address - Phone:860-779-0321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2025-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO171347363LF0000X
AZAP2570363LF0000X
COAPN.0005051-NP363LP0808X
COAPN0005051363LP0808X
CT13864363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily