Provider Demographics
NPI:1164208815
Name:NANZ, LINDSEY CAMILLE (MS)
Entity Type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:CAMILLE
Last Name:NANZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5677 GRANDIN ROAD EXT
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-7863
Mailing Address - Country:US
Mailing Address - Phone:540-492-1249
Mailing Address - Fax:
Practice Address - Street 1:1211 S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-4705
Practice Address - Country:US
Practice Address - Phone:540-985-9885
Practice Address - Fax:540-857-9130
Is Sole Proprietor?:No
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0140000050170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS