Provider Demographics
NPI:1326121567
Name:FOWKES, LINDSAY ANNETTE (C-FNP)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:ANNETTE
Last Name:FOWKES
Suffix:
Gender:F
Credentials:C-FNP
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:ANNETTE
Other - Last Name:SILCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:PO BOX 1615
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26507-1615
Mailing Address - Country:US
Mailing Address - Phone:304-599-1448
Mailing Address - Fax:304-599-5335
Practice Address - Street 1:1000 MON HEALTH MEDICAL PARK DR STE 1103
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-1143
Practice Address - Country:US
Practice Address - Phone:304-599-1448
Practice Address - Fax:304-599-5335
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV57337363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
001719641OtherBLUE CROSS BLUE SHIELD
WV3810000786Medicaid
WV3810000786Medicaid
WVPO01453585OtherRAILROAD MEDICARE
WVWV5187C185OtherMEDICARE