Provider Demographics
NPI:1700210473
Name:ASHLEY, LINDSEY MARIE (PA)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:MARIE
Last Name:ASHLEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:MARIE
Other - Last Name:GONIU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:600 GRANT ST
Mailing Address - Street 2:1509
Mailing Address - City:GARY
Mailing Address - State:IN
Mailing Address - Zip Code:46402-6001
Mailing Address - Country:US
Mailing Address - Phone:219-886-4710
Mailing Address - Fax:
Practice Address - Street 1:600 GRANT ST
Practice Address - Street 2:
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46402-6001
Practice Address - Country:US
Practice Address - Phone:219-886-4710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-29
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10001573A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant