Provider Demographics
NPI:1972214310
Name:CARDONE, LYNNETTE
Entity type:Individual
Prefix:
First Name:LYNNETTE
Middle Name:
Last Name:CARDONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06117-2674
Mailing Address - Country:US
Mailing Address - Phone:860-216-2007
Mailing Address - Fax:860-321-8923
Practice Address - Street 1:309 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06117-2674
Practice Address - Country:US
Practice Address - Phone:860-216-2007
Practice Address - Fax:860-321-8923
Is Sole Proprietor?:No
Enumeration Date:2022-12-07
Last Update Date:2025-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT137470163W00000X
CT012868363LP0808X, 364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health