Lynda Rae Hedstrom, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN141151 NP Issued in GA

Practice address

3720 Davinci CT
Suite 400
Norcross, GA 30092-7627

Phone

(770) 582-4190

Fax

(770) 582-4189

NPI assigned

Jan 15, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659422962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3542 MILL RD",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305045520",
            "telephone_number": "770-297-8072",
            "fax_number": "770-582-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 DAVINCI CT",
            "address_2": "SUITE 400",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300927627",
            "telephone_number": "770-582-4190",
            "fax_number": "770-582-4189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDSTROM",
        "first_name": "LYNDA",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN141151 NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Norcross, GA
• Providers in Norcross, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.