Provider Demographics
NPI:1265708671
Name:ANDERSON, LYNDSAY W (MSN, FNP)
Entity type:Individual
Prefix:
First Name:LYNDSAY
Middle Name:W
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:
Other - First Name:LYNDSAY
Other - Middle Name:T
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:6000 J ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95819-2605
Mailing Address - Country:US
Mailing Address - Phone:973-650-8280
Mailing Address - Fax:
Practice Address - Street 1:6000 J STREET
Practice Address - Street 2:CSU SACRAMENTO SCHOOL OF NURSING
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819
Practice Address - Country:US
Practice Address - Phone:973-650-8280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-29
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95005903363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95110898OtherCALIFORNIA BOARD OF REGISTERED NURSING
CA95005903OtherCALIFORNIA BOARD OF REGISTERED NURSING