Provider Demographics
NPI:1043766934
Name:VANCE, LINDSAY DEANNE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:DEANNE
Last Name:VANCE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2403 BROWNS MILL ROAD
Mailing Address - Street 2:APARTMENT 15
Mailing Address - City:JOHNSONCITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604
Mailing Address - Country:US
Mailing Address - Phone:276-274-8137
Mailing Address - Fax:
Practice Address - Street 1:2403 BROWNS MILL RD
Practice Address - Street 2:APARTMENT 15
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-1972
Practice Address - Country:US
Practice Address - Phone:276-274-8137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-30
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202214994183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist