Provider Demographics
NPI:1164019394
Name:FANSLER, LINDSEY RHEA
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:RHEA
Last Name:FANSLER
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 1:9304 FREEDOM RD UNIT 633
Mailing Address - Street 2:
Mailing Address - City:SAPULPA
Mailing Address - State:OK
Mailing Address - Zip Code:74066-2186
Mailing Address - Country:US
Mailing Address - Phone:539-323-0256
Mailing Address - Fax:
Practice Address - Street 1:9304 FREEDOM RD UNIT 633
Practice Address - Street 2:
Practice Address - City:SAPULPA
Practice Address - State:OK
Practice Address - Zip Code:74066-2186
Practice Address - Country:US
Practice Address - Phone:539-323-0256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator