Provider Demographics
NPI:1255525135
Name:BUSHNELL, LINDSAY ANN (CPM, NHCM)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:ANN
Last Name:BUSHNELL
Suffix:
Gender:F
Credentials:CPM, NHCM
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:ANN
Other - Last Name:JOHNSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:BROWNFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04010
Mailing Address - Country:US
Mailing Address - Phone:207-890-7356
Mailing Address - Fax:207-935-1565
Practice Address - Street 1:11 RIVER RD
Practice Address - Street 2:
Practice Address - City:LIMINGTON
Practice Address - State:ME
Practice Address - Zip Code:04049-4734
Practice Address - Country:US
Practice Address - Phone:207-890-7356
Practice Address - Fax:207-935-1565
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-04
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
175M00000X, 176B00000X
NH1038176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No175M00000XOther Service ProvidersMidwife, Lay
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30468606Medicaid