Provider Demographics
NPI:1326602681
Name:GILBERT, LINDSEY (PA)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:GILBERT
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:
Other - Last Name:RICKMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:6301 DENMEADE DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-1890
Mailing Address - Country:US
Mailing Address - Phone:678-978-5477
Mailing Address - Fax:
Practice Address - Street 1:275 COLLIER RD NW STE 300
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1740
Practice Address - Country:US
Practice Address - Phone:404-350-0009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-23
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
GA10415363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program