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General NPI Number Information
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NPI Number | 1255655916
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Entity Type | Individual
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Provider Name | LYNDSAY ALLISON BULGER CRNA, RN
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Gender | Female
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Dates
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Enumeration Date | 03/23/2010
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Last Update Date | 12/14/2021
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Provider Practice Location Address
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Address Line | 15 GLEN ECHO
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City | DOVE CANYON
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State | CA
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Zip | 92679
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Country | US
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Telephone | 310-279-3664
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Fax |
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Provider Business Mailing Address
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Address Line | 22 INDIAN PIPE
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City | DOVE CANYON
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State | CA
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Zip | 92679-4206
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Country | US
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Telephone | 310-279-3664
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 664191
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 3990
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License Number State | CA
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