Provider Demographics
NPI:1629301981
Name:MUNDEN, LINDSAY ALLISON (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:ALLISON
Last Name:MUNDEN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MS
Other - First Name:LINDSAY
Other - Middle Name:ALLISON
Other - Last Name:JAROSAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:314 W SEDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46385-0008
Mailing Address - Country:US
Mailing Address - Phone:219-405-3506
Mailing Address - Fax:
Practice Address - Street 1:951 SOUTHPOINT CIR STE B
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46385-6282
Practice Address - Country:US
Practice Address - Phone:219-286-7121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-17
Last Update Date:2022-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209008831363LF0000X
IN28165546A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily