Provider Demographics
NPI:1164986345
Name:BERTSCH, LINDSAY DEANN
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:DEANN
Last Name:BERTSCH
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 1:51456 S COUNTY ROAD 2705
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:OK
Mailing Address - Zip Code:73718-2900
Mailing Address - Country:US
Mailing Address - Phone:580-794-0663
Mailing Address - Fax:
Practice Address - Street 1:51456 S COUNTY ROAD 2705
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:OK
Practice Address - Zip Code:73718-2900
Practice Address - Country:US
Practice Address - Phone:580-794-0663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-22
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator