Provider Demographics
NPI:1649762139
Name:WASH, LYNDSEY LEEANN (PA-C)
Entity Type:Individual
Prefix:
First Name:LYNDSEY
Middle Name:LEEANN
Last Name:WASH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LYNDSEY
Other - Middle Name:LEEANN
Other - Last Name:TERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5012 MUD LAKE RD
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33567-2502
Mailing Address - Country:US
Mailing Address - Phone:813-477-6201
Mailing Address - Fax:
Practice Address - Street 1:2502 W SAINT ISABEL ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6370
Practice Address - Country:US
Practice Address - Phone:813-874-5707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2021-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant