Provider Demographics
NPI:1245592393
Name:TOMMASIN, LINDY JO (ARNP)
Entity Type:Individual
Prefix:
First Name:LINDY
Middle Name:JO
Last Name:TOMMASIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 PARK ST
Mailing Address - Street 2:
Mailing Address - City:MAYNARD
Mailing Address - State:IA
Mailing Address - Zip Code:50655-7571
Mailing Address - Country:US
Mailing Address - Phone:319-240-5035
Mailing Address - Fax:
Practice Address - Street 1:1089 JORDAN CREEK PKWY STE 200
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-5830
Practice Address - Country:US
Practice Address - Phone:515-531-8013
Practice Address - Fax:833-983-2836
Is Sole Proprietor?:No
Enumeration Date:2012-06-14
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA-122145363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1245592393Medicaid
IA1245592393Medicaid