Provider Demographics
NPI:1003276189
Name:OSTERMEIER, LINDSEY (FNP)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:OSTERMEIER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:N
Other - Last Name:HAINES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3220 ATLANTA ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62707-8801
Mailing Address - Country:US
Mailing Address - Phone:217-588-7400
Mailing Address - Fax:
Practice Address - Street 1:3220 ATLANTA ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62707-8801
Practice Address - Country:US
Practice Address - Phone:217-588-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-02
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209013879363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
F0116224OtherAANP CERTIFICATION