Healthcare Provider Details

I. General information

NPI: 1316463094
Provider Name (Legal Business Name): LINDSAY SUE CROSSAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSAY WILLIAMS NP

II. Dates (important events)

Enumeration Date: 08/15/2017
Last Update Date: 04/02/2024
Certification Date: 04/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 COMMONWEALTH AVE
BOSTON MA
02215-1274
US

IV. Provider business mailing address

960 MASSACHUSETTS AVENUE FL 2
BOSTON MA
02118-2690
US

V. Phone/Fax

Practice location:
  • Phone: 617-417-6800
  • Fax: 617-414-6817
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2310371
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: