Provider Demographics
NPI:1699389189
Name:PELL, LINDSAY RANAE (FNP)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:RANAE
Last Name:PELL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 HILL ST
Mailing Address - Street 2:
Mailing Address - City:ELLISVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39437-2521
Mailing Address - Country:US
Mailing Address - Phone:601-800-0118
Mailing Address - Fax:601-800-0119
Practice Address - Street 1:305 HILL ST
Practice Address - Street 2:
Practice Address - City:ELLISVILLE
Practice Address - State:MS
Practice Address - Zip Code:39437-2521
Practice Address - Country:US
Practice Address - Phone:601-800-0118
Practice Address - Fax:601-800-0119
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-02
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS903921363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily