Provider Demographics
NPI:1366835969
Name:GILBERT, LINDSAY MARIE (PA-C)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:MARIE
Last Name:GILBERT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:
Other - Last Name:WRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:409 S 2ND ST
Mailing Address - Street 2:SUITE 2F
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1612
Mailing Address - Country:US
Mailing Address - Phone:717-791-2520
Mailing Address - Fax:717-703-0061
Practice Address - Street 1:2005 TECHNOLOGY PKWY
Practice Address - Street 2:SUITE 400
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-9413
Practice Address - Country:US
Practice Address - Phone:717-791-2520
Practice Address - Fax:717-703-0061
Is Sole Proprietor?:No
Enumeration Date:2015-03-06
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA057386363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103142002Medicaid
PA401605Medicare PIN