Provider Demographics
NPI:1073255972
Name:WILFERD, LINDSEY PAIGE
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:PAIGE
Last Name:WILFERD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 POPLAR ST STE 104
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-2577
Mailing Address - Country:US
Mailing Address - Phone:270-534-5128
Mailing Address - Fax:
Practice Address - Street 1:111 POPLAR ST STE 104
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-2577
Practice Address - Country:US
Practice Address - Phone:270-534-5128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-11
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program