Provider Demographics
NPI:1598357857
Name:LANCASTER, LINDSEY V
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:V
Last Name:LANCASTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:V
Other - Last Name:BOREN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3261 24TH AVE NW STE 101
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-6666
Mailing Address - Country:US
Mailing Address - Phone:405-364-6432
Mailing Address - Fax:
Practice Address - Street 1:3261 24TH AVE NW STE 101
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6666
Practice Address - Country:US
Practice Address - Phone:405-364-6432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-08
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKRN0090016163W00000X
OK204257363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse