Provider Demographics
NPI:1689279978
Name:COUSINS, LINDSAY KAYE (NNP)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:KAYE
Last Name:COUSINS
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 SCENIC PARK CT
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77640-2066
Mailing Address - Country:US
Mailing Address - Phone:409-540-3054
Mailing Address - Fax:
Practice Address - Street 1:3080 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-4606
Practice Address - Country:US
Practice Address - Phone:409-212-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-03
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1020698363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal