Provider Demographics
NPI:1881879690
Name:LUNDY, LAUREN (FNP-C)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:LUNDY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:VAN DYKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:HUDSON VALLEY HOSPICE, INC
Mailing Address - Street 2:374 VIOLET AVENUE
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-1034
Mailing Address - Country:US
Mailing Address - Phone:845-473-2273
Mailing Address - Fax:845-790-0009
Practice Address - Street 1:HUDSON VALLEY HOSPICE, INC
Practice Address - Street 2:374 VIOLET AVENUE
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1034
Practice Address - Country:US
Practice Address - Phone:845-473-2273
Practice Address - Fax:845-790-0009
Is Sole Proprietor?:No
Enumeration Date:2007-12-31
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004819363LF0000X
NY337034363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04003476Medicaid