Provider Demographics
NPI:1558582106
Name:FAUSNAUGH, LINDSEY (RD, LD)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:FAUSNAUGH
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 346
Mailing Address - Street 2:
Mailing Address - City:MOUNT STERLING
Mailing Address - State:OH
Mailing Address - Zip Code:43143-9059
Mailing Address - Country:US
Mailing Address - Phone:614-989-5058
Mailing Address - Fax:
Practice Address - Street 1:16703 WHITESIDE RD
Practice Address - Street 2:
Practice Address - City:MOUNT STERLING
Practice Address - State:OH
Practice Address - Zip Code:43143-9059
Practice Address - Country:US
Practice Address - Phone:740-779-7500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2020-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
OHLD.5920133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered