Provider Demographics
NPI:1578252516
Name:JACKSON, LINDSAY OSTEEN (APRN)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:OSTEEN
Last Name:JACKSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2532 WHITE HORSE RD W
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32246-2493
Mailing Address - Country:US
Mailing Address - Phone:386-688-4093
Mailing Address - Fax:
Practice Address - Street 1:2532 WHITE HORSE RD W
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-2493
Practice Address - Country:US
Practice Address - Phone:386-688-4093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11026139363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner