Provider Demographics
NPI:1679815930
Name:CAINE-CONLEY, LINDSAY R
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:R
Last Name:CAINE-CONLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:738 MADISON AVE APT C
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-2138
Mailing Address - Country:US
Mailing Address - Phone:651-334-2216
Mailing Address - Fax:
Practice Address - Street 1:103 S PANTOPS DR STE 102
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8617
Practice Address - Country:US
Practice Address - Phone:434-220-0080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-25
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110004186363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant