Provider Demographics
NPI:1073943551
Name:MORAN, LINDSAY MARGARET (NP-C)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:MARGARET
Last Name:MORAN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7675 DAGGET ST STE 370
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-2260
Mailing Address - Country:US
Mailing Address - Phone:858-309-6585
Mailing Address - Fax:858-309-6593
Practice Address - Street 1:477 N EL CAMINO REAL
Practice Address - Street 2:STE. D200
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1328
Practice Address - Country:US
Practice Address - Phone:760-747-8935
Practice Address - Fax:760-452-3344
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95083773363L00000X
NE111603363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95083773OtherMEDICAL LICENSE
CA95083773OtherMEDICAL LICENSE