Provider Demographics
NPI:1225549249
Name:LAMOUREAUX, LINDSAY JEAN (PA)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:JEAN
Last Name:LAMOUREAUX
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MRS
Other - First Name:LINDSAY
Other - Middle Name:JEAN
Other - Last Name:DOLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:9200 AYLESBURY LN
Mailing Address - Street 2:
Mailing Address - City:MINT HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28227-0403
Mailing Address - Country:US
Mailing Address - Phone:704-606-0770
Mailing Address - Fax:
Practice Address - Street 1:280 EXECUTIVE PARK DR STE 100
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-1838
Practice Address - Country:US
Practice Address - Phone:704-786-8220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-07646363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant