Lindsay Marie Bukowski, CRNP
Individual provider Active NPI Family Nurse Practitioner · Old Forge, PA
NPI 1578063335 · NPPES record last updated Mar 6, 2020
Key facts
- NPI
- 1578063335
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- SP018507 (PA)
- Practice address
- 315 S Main St
Old Forge, PA 18518-1790 - Phone
- (570) 457-8364
- NPI assigned
- Feb 19, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180601002182 | PA | Practitioner - Nurse Practitioner | 7517222037 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Scranton Quincy Clinic Company LLC | Family | Current |
Accepting new patients |
Locations
150 Brooklyn St
Carbondale, PA 18407
Phone (570) 282-2031
315 S Main St
Old Forge, PA 18518
Phone (570) 457-8364
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | SP018507 | PA | Yes |
Addresses
Primary practice location
315 S Main St
Old Forge, PA 18518-1790
Mailing address
406 Boulevard Ave
Dickson City, PA 18519-1729
Phone (570) 877-4846
Other providers in Old Forge, PA
- Michael Patrick Bilski
- Stephen Brosky
- Nicole Brush
- Stephen Brush
- Russell S Bufalino
- Timothy Burns
- Capitano Pharmaceutical Services Inc
- Capitano'S Pharmacy
- Sharon Brady Chase
- Chiavacci Orthopedics, PC
All providers in Old Forge, PA · Family Nurse Practitioner in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.