Provider Demographics
NPI:1477445336
Name:MACK, LYNDSEY LEA (NP)
Entity type:Individual
Prefix:
First Name:LYNDSEY
Middle Name:LEA
Last Name:MACK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 COOLRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-2767
Mailing Address - Country:US
Mailing Address - Phone:828-694-3939
Mailing Address - Fax:
Practice Address - Street 1:165 COOLRIDGE ST
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-2767
Practice Address - Country:US
Practice Address - Phone:828-694-3939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5022581363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily