Provider Demographics
NPI:1689924623
Name:BRONSTEIN, LINDSEY (NP)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:BRONSTEIN
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:937-578-2020
Mailing Address - Fax:937-578-2019
Practice Address - Street 1:500 LONDON AVE STE O
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-3570
Practice Address - Country:US
Practice Address - Phone:937-578-2020
Practice Address - Fax:937-578-2019
Is Sole Proprietor?:No
Enumeration Date:2012-09-18
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16776363L00000X
OH16611363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner