Provider Demographics
NPI:1407543085
Name:LINDO, COLLEEN (CRNP)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:LINDO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1927 YORK RD
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-4225
Mailing Address - Country:US
Mailing Address - Phone:443-681-9893
Mailing Address - Fax:
Practice Address - Street 1:1927 YORK RD
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-4225
Practice Address - Country:US
Practice Address - Phone:443-681-9893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-24
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTPAN1785363LF0000X
VA0024188461363LF0000X
UT13534537-4405363LP2300X
MDR188706363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily