Provider Demographics
NPI:1194369884
Name:GWALTNEY, LINDSAY D (FNP)
Entity Type:Individual
Prefix:MS
First Name:LINDSAY
Middle Name:D
Last Name:GWALTNEY
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Gender:F
Credentials:FNP
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Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:CB 8127
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-362-3500
Mailing Address - Fax:314-362-3454
Practice Address - Street 1:1 BARNES JEWISH HOSPITAL PLZ
Practice Address - Street 2:DIV IM ENDOCRINOLOGY
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1003
Practice Address - Country:US
Practice Address - Phone:314-362-3500
Practice Address - Fax:314-362-3454
Is Sole Proprietor?:No
Enumeration Date:2019-11-05
Last Update Date:2022-07-20
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Provider Licenses
StateLicense IDTaxonomies
MO2020039937363LF0000X, 363L00000X
TN26527363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420100267Medicaid