Provider Demographics
NPI:1144424268
Name:MINICK, LINDSAY ANNE (CM-A, BA, BHRS)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:ANNE
Last Name:MINICK
Suffix:
Gender:F
Credentials:CM-A, BA, BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7615 N 122ND EAST AVE
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-3557
Mailing Address - Country:US
Mailing Address - Phone:918-639-7731
Mailing Address - Fax:
Practice Address - Street 1:2325 S HARVARD AVE STE 500
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-3305
Practice Address - Country:US
Practice Address - Phone:918-513-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator