Provider Demographics
NPI:1033702832
Name:MORTENSEN, LINDSEY GRAY (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:GRAY
Last Name:MORTENSEN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1806 E 250 S
Mailing Address - Street 2:
Mailing Address - City:SPRINGVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84663-2766
Mailing Address - Country:US
Mailing Address - Phone:801-367-1490
Mailing Address - Fax:
Practice Address - Street 1:1806 E 250 S
Practice Address - Street 2:
Practice Address - City:SPRINGVILLE
Practice Address - State:UT
Practice Address - Zip Code:84663-2766
Practice Address - Country:US
Practice Address - Phone:801-367-1490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-12
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6393367-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily