Provider Demographics
NPI:1033441233
Name:HENDERSON, LINDSAY ERIN (NP)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:ERIN
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 NEWPORT TOWNE CTR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37821-7391
Mailing Address - Country:US
Mailing Address - Phone:423-532-8621
Mailing Address - Fax:423-532-8704
Practice Address - Street 1:121 NEWPORT TOWNE CTR
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:TN
Practice Address - Zip Code:37821-7391
Practice Address - Country:US
Practice Address - Phone:423-532-8621
Practice Address - Fax:423-532-8704
Is Sole Proprietor?:No
Enumeration Date:2010-02-12
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TNAPN14848363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1517211Medicaid