Provider Demographics
NPI:1376009274
Name:HEDRICK, LINDSAY REBEKAH (APRN)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:REBEKAH
Last Name:HEDRICK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4877 69TH ST E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-4675
Mailing Address - Country:US
Mailing Address - Phone:207-423-2571
Mailing Address - Fax:
Practice Address - Street 1:2010 59TH ST W STE 2200
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-4689
Practice Address - Country:US
Practice Address - Phone:941-794-5621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-15
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11001448363LF0000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLYCSYFOtherBCBS
FL104148600Medicaid