Provider Demographics
NPI:1285652412
Name:LINDSAY, PATRICIA ANNE (NP)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ANNE
Last Name:LINDSAY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 615
Mailing Address - Street 2:
Mailing Address - City:PONTOTOC
Mailing Address - State:MS
Mailing Address - Zip Code:38863-0615
Mailing Address - Country:US
Mailing Address - Phone:662-509-9934
Mailing Address - Fax:662-509-9935
Practice Address - Street 1:109 HIGHWAY 15 S
Practice Address - Street 2:
Practice Address - City:PONTOTOC
Practice Address - State:MS
Practice Address - Zip Code:38863-2628
Practice Address - Country:US
Practice Address - Phone:662-509-9934
Practice Address - Fax:662-509-9935
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR573272363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00124136Medicaid
MS00124136Medicaid