Provider Demographics
NPI:1225442296
Name:CONNER, LINDSAY (MD, MPH)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:CONNER
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:
Other - Last Name:JANICKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:423 N 3RD AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-1511
Mailing Address - Country:US
Mailing Address - Phone:208-263-2173
Mailing Address - Fax:
Practice Address - Street 1:423 N 3RD AVE STE 210
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-1511
Practice Address - Country:US
Practice Address - Phone:208-263-2173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT67110207V00000X
NC2016-01910390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program