Provider Demographics
NPI:1902560105
Name:CORNELL, LYNDSAY DARLENE (LPN)
Entity Type:Individual
Prefix:MISS
First Name:LYNDSAY
Middle Name:DARLENE
Last Name:CORNELL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14701-8024
Mailing Address - Country:US
Mailing Address - Phone:171-645-0907
Mailing Address - Fax:
Practice Address - Street 1:1899 WINCH RD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NY
Practice Address - Zip Code:14750-9611
Practice Address - Country:US
Practice Address - Phone:716-450-9073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-25
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY323992164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse