Provider Demographics
NPI:1003392606
Name:STANTON, LINDSEY (CRNP)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:STANTON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10530 ROSEHAVEN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-2888
Mailing Address - Country:US
Mailing Address - Phone:703-938-0363
Mailing Address - Fax:703-938-8653
Practice Address - Street 1:10530 ROSEHAVEN ST STE 100
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-2888
Practice Address - Country:US
Practice Address - Phone:703-938-0363
Practice Address - Fax:703-938-8653
Is Sole Proprietor?:No
Enumeration Date:2018-07-17
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR208635363LF0000X
VA0024178849363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily