Basic Information
| Provider Information | |||||||||
| NPI: | 1912452699 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KENNEDY | ||||||||
| FirstName: | LINDSAY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 45 HUDSON AVE | ||||||||
| Address2: | |||||||||
| City: | GLENS FALLS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 128014313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5187934477 | ||||||||
| FaxNumber: | 5189320545 | ||||||||
| Practice Location | |||||||||
| Address1: | 45 HUDSON AVE | ||||||||
| Address2: | |||||||||
| City: | GLENS FALLS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 128014313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5187934477 | ||||||||
| FaxNumber: | 5189320545 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2016 | ||||||||
| LastUpdateDate: | 08/23/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | 001753 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.