Provider Demographics
NPI:1235371980
Name:BROWN, LINDSAY T (MS, RD)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:T
Last Name:BROWN
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:CAROL
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:655 E RIVER RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-5840
Mailing Address - Country:US
Mailing Address - Phone:520-694-2700
Mailing Address - Fax:
Practice Address - Street 1:1501 N CAMPBELL AVE RM 3324
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85724-0001
Practice Address - Country:US
Practice Address - Phone:520-626-6077
Practice Address - Fax:520-626-2881
Is Sole Proprietor?:No
Enumeration Date:2009-03-26
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ926373133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ417000Medicaid
AZZ128661Medicare PIN