Provider Demographics
NPI:1275855504
Name:WITT, LINDSEY L (WHNP)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:L
Last Name:WITT
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:L
Other - Last Name:WATRUD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2959 SHARPSBURG MCCULLUM RD
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-2297
Mailing Address - Country:US
Mailing Address - Phone:770-683-8346
Mailing Address - Fax:770-916-7642
Practice Address - Street 1:2959 SHARPSBURG MCCOLLUM RD
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-2297
Practice Address - Country:US
Practice Address - Phone:770-683-8346
Practice Address - Fax:770-916-7642
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-01
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN180347363LW0102X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN180347OtherGEORGIA LICENSE