Provider Demographics
NPI:1598148108
Name:WAHLSTROM, LINDSAY NADINE (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:NADINE
Last Name:WAHLSTROM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10787 NALL AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1301
Mailing Address - Country:US
Mailing Address - Phone:913-945-6900
Mailing Address - Fax:913-945-6970
Practice Address - Street 1:10787 NALL AVE STE 310
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1301
Practice Address - Country:US
Practice Address - Phone:913-945-6800
Practice Address - Fax:913-945-6970
Is Sole Proprietor?:No
Enumeration Date:2015-06-30
Last Update Date:2024-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO004981207R00000X
KS04-40837207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine