Provider Demographics
NPI:1417289067
Name:WILLIAMS, LINDSEY JO (CRNA)
Entity Type:Individual
Prefix:MS
First Name:LINDSEY
Middle Name:JO
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CRNA
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Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:C B 8054
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-996-8378
Mailing Address - Fax:314-996-8710
Practice Address - Street 1:12634 OLIVE BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6337
Practice Address - Country:US
Practice Address - Phone:314-996-8378
Practice Address - Fax:314-996-8710
Is Sole Proprietor?:No
Enumeration Date:2010-02-08
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2013032488367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered