Provider Demographics
NPI:1659049302
Name:MISITA, LINDSEY OLIVER (FNP-C)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:OLIVER
Last Name:MISITA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 WALNUT ST.
Mailing Address - Street 2:
Mailing Address - City:AMITE
Mailing Address - State:LA
Mailing Address - Zip Code:70422
Mailing Address - Country:US
Mailing Address - Phone:985-284-2400
Mailing Address - Fax:985-748-8144
Practice Address - Street 1:409 NW CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:AMITE
Practice Address - State:LA
Practice Address - Zip Code:70422
Practice Address - Country:US
Practice Address - Phone:985-748-7141
Practice Address - Fax:985-748-3181
Is Sole Proprietor?:No
Enumeration Date:2021-08-30
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA221568363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily