Provider Demographics
NPI:1699393603
Name:WOODALL, LINDSEY BROOKE (APRN)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:BROOKE
Last Name:WOODALL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2705 RICHLAND PARK DR
Mailing Address - Street 2:
Mailing Address - City:BRYANT
Mailing Address - State:AR
Mailing Address - Zip Code:72022-2689
Mailing Address - Country:US
Mailing Address - Phone:870-692-5673
Mailing Address - Fax:
Practice Address - Street 1:150 E SIEBENMORGEN RD
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-4000
Practice Address - Country:US
Practice Address - Phone:870-692-5673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-07
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR124000363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily