Provider Demographics
NPI:1356821284
Name:WILSON, LINDSAY MICHELLE (APRN- FNP)
Entity Type:Individual
Prefix:MS
First Name:LINDSAY
Middle Name:MICHELLE
Last Name:WILSON
Suffix:
Gender:F
Credentials:APRN- FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2805 GOLDFINCH DR
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75181-4924
Mailing Address - Country:US
Mailing Address - Phone:214-354-7656
Mailing Address - Fax:
Practice Address - Street 1:2727 BOLTON BOONE DR STE 102
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2019
Practice Address - Country:US
Practice Address - Phone:972-283-8777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX822369163WG0000X
TXAP137386363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice