Provider Demographics
NPI:1578746525
Name:HUMES, LINDSAY DAWN (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:DAWN
Last Name:HUMES
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2245 N 400 E
Mailing Address - Street 2:STE 301
Mailing Address - City:NORTH LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84341-1892
Mailing Address - Country:US
Mailing Address - Phone:435-753-7880
Mailing Address - Fax:435-753-5845
Practice Address - Street 1:2245 N 400 E
Practice Address - Street 2:STE 301
Practice Address - City:NORTH LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341-1892
Practice Address - Country:US
Practice Address - Phone:435-753-7880
Practice Address - Fax:435-753-5845
Is Sole Proprietor?:No
Enumeration Date:2007-12-13
Last Update Date:2022-06-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT6719295-1206363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical