Provider Demographics
NPI:1124417100
Name:GAINES, LINDSAY BROOKE (AA)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:BROOKE
Last Name:GAINES
Suffix:
Gender:F
Credentials:AA
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:BROOKE
Other - Last Name:OUTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:31 PALMETTO BAY RD
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31410-2651
Mailing Address - Country:US
Mailing Address - Phone:912-441-4125
Mailing Address - Fax:912-350-7036
Practice Address - Street 1:4700 WATERS AVE
Practice Address - Street 2:MEMORIAL HEALTH ANESTHETISTS
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-6220
Practice Address - Country:US
Practice Address - Phone:912-350-8977
Practice Address - Fax:912-350-7036
Is Sole Proprietor?:No
Enumeration Date:2015-01-14
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
367H00000X
GA007371367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant