Provider Demographics
NPI:1497309322
Name:CASTLEBERRY, LINDSEY ANN (PA-C)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:ANN
Last Name:CASTLEBERRY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 E 800 N
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84660-1209
Mailing Address - Country:US
Mailing Address - Phone:801-794-1490
Mailing Address - Fax:
Practice Address - Street 1:114 E 800 N
Practice Address - Street 2:
Practice Address - City:SPANISH FORK
Practice Address - State:UT
Practice Address - Zip Code:84660-1209
Practice Address - Country:US
Practice Address - Phone:801-318-1168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-29
Last Update Date:2022-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant