Provider Demographics
NPI:1477920296
Name:LINDO, JACKIE-JOE B (FNP)
Entity Type:Individual
Prefix:MRS
First Name:JACKIE-JOE
Middle Name:B
Last Name:LINDO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:JACKIE-JOE
Other - Middle Name:B
Other - Last Name:LINDO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FAMILY NP
Mailing Address - Street 1:5309 LIMESTONE RD STE B
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-1222
Mailing Address - Country:US
Mailing Address - Phone:302-604-3448
Mailing Address - Fax:302-235-8151
Practice Address - Street 1:5309 LIMESTONE RD STE B
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-1222
Practice Address - Country:US
Practice Address - Phone:302-604-3448
Practice Address - Fax:302-235-8151
Is Sole Proprietor?:No
Enumeration Date:2015-08-27
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0037657163W00000X
DELG0000878363LF0000X
DELG-0000878363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily