Provider Demographics
NPI:1447806203
Name:MORETTA, LINDSEY (RN, BSN, MSN-FNP)
Entity Type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:
Last Name:MORETTA
Suffix:
Gender:F
Credentials:RN, BSN, MSN-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:965 RIDGE LAKE BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-9446
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:901-227-8591
Practice Address - Street 1:6025 WALNUT GROVE RD STE 627
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-2126
Practice Address - Country:US
Practice Address - Phone:901-767-3321
Practice Address - Fax:901-767-3908
Is Sole Proprietor?:No
Enumeration Date:2019-08-16
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26414363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily