Provider Demographics
NPI:1902354111
Name:MAHER, LINDSAY (NP)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:MAHER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:
Other - Last Name:HORAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:7045 SURFBIRD CIR
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-4018
Mailing Address - Country:US
Mailing Address - Phone:617-447-0790
Mailing Address - Fax:
Practice Address - Street 1:3900 FIFTH AVE
Practice Address - Street 2:SUITE 140
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-3121
Practice Address - Country:US
Practice Address - Phone:619-365-9959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-16
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA724747363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner