Basic Information
| Provider Information | |||||||||
| NPI: | 1679034284 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LINDAHL | ||||||||
| FirstName: | BRITTANY | ||||||||
| MiddleName: | D'NEL | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 6 | ||||||||
| Address2: | |||||||||
| City: | HEILWOOD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 157450006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8144215939 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2128 OAKLAND AVE | ||||||||
| Address2: | |||||||||
| City: | INDIANA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 157013384 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7243494362 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2019 | ||||||||
| LastUpdateDate: | 09/25/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | SP020175 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 103652294-0001 | 05 | PA | MEDICAID |