Basic Information
| Provider Information | |||||||||
| NPI: | 1770259699 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DAY | ||||||||
| FirstName: | LYNDSAY | ||||||||
| MiddleName: | MAY | ||||||||
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| OtherLastName: | WEESE | ||||||||
| OtherFirstName: | LYNDSAY | ||||||||
| OtherMiddleName: | MAY | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 30 PINE GROVE AVE | ||||||||
| Address2: | |||||||||
| City: | GLENBURN | ||||||||
| State: | ME | ||||||||
| PostalCode: | 044011455 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2074310072 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 42 CEDAR ST | ||||||||
| Address2: | |||||||||
| City: | BANGOR | ||||||||
| State: | ME | ||||||||
| PostalCode: | 044016433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2079470366 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/19/2021 | ||||||||
| LastUpdateDate: | 12/28/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN68021 | ME | N | Nursing Service Providers | Registered Nurse | 363LP0808X | CNP211165 | ME | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.