MEDICARE: LYNDSIE NICOLE BANGE NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	RN268868	GA
2	363LF0000X	Family Nurse Practitioner	1-168624	AL

General Provider Information

NPI Number	:	1689257255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNDSIE NICOLE BANGE NP

Provider Business Mailing Address
First Line	:	140 VILLAGE ST STE 100
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35242-6436
Country	:	US
Telephone Number	:	205-980-1744
Fax Number	:	205-980-1334

Provider Business Practice Location Address
First Line	:	140 VILLAGE ST STE 100
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35242-6436
Country	:	US
Telephone Number	:	205-980-1744
Fax Number	:	205-980-1334

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2021
Last Update Date	:	03/14/2024

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Directions to “ LYNDSIE NICOLE BANGE NP” Practice Location

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