Basic Information
Provider Information
NPI: 1356995187
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VALLEE
FirstName: LYNDSEY
MiddleName: MICHELE
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7 ALUMNI DR FL 1
Address2:  
City: EXETER
State: NH
PostalCode: 038332118
CountryCode: US
TelephoneNumber: 6037722981
FaxNumber: 6037720931
Practice Location
Address1: 4 ALUMNI DR
Address2:  
City: EXETER
State: NH
PostalCode: 038332118
CountryCode: US
TelephoneNumber: 6037722981
FaxNumber: 6037720931
Other Information
ProviderEnumerationDate: 07/30/2019
LastUpdateDate: 12/14/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/14/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X072107-23NHY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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