Provider Demographics
NPI:1447616222
Name:SMITH, LINDSAY BROOKE BLANCHARD (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:BROOKE BLANCHARD
Last Name:SMITH
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 1:267 STRATHAVEN LN
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-6252
Mailing Address - Country:US
Mailing Address - Phone:205-602-8486
Mailing Address - Fax:
Practice Address - Street 1:267 STRATHAVEN LN
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-6252
Practice Address - Country:US
Practice Address - Phone:205-602-8486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-08
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALAG1015083363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology