Provider Demographics
NPI:1407223928
Name:WARNER, LINDSEY JO (PA-C)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:JO
Last Name:WARNER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:JO
Other - Last Name:SIMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:503 GREENWOOD TRACE DR
Mailing Address - Street 2:
Mailing Address - City:WHITELAND
Mailing Address - State:IN
Mailing Address - Zip Code:46184-9278
Mailing Address - Country:US
Mailing Address - Phone:317-535-7447
Mailing Address - Fax:317-535-0262
Practice Address - Street 1:503 GREENWOOD TRACE DR
Practice Address - Street 2:
Practice Address - City:WHITELAND
Practice Address - State:IN
Practice Address - Zip Code:46184-9278
Practice Address - Country:US
Practice Address - Phone:317-535-7447
Practice Address - Fax:317-535-0262
Is Sole Proprietor?:No
Enumeration Date:2015-09-01
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10001881A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1487680518OtherGROUP NPI