Provider Demographics
NPI:1417419177
Name:COULTER, LINDSAY ANN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:ANN
Last Name:COULTER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:ANN
Other - Last Name:TARLETON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4299 MAHONING AVE NW
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-1928
Mailing Address - Country:US
Mailing Address - Phone:234-806-3137
Mailing Address - Fax:234-806-3138
Practice Address - Street 1:4299 MAHONING AVE NW
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-1928
Practice Address - Country:US
Practice Address - Phone:234-806-3137
Practice Address - Fax:234-806-3138
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03135715183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist