Provider Demographics
NPI:1700838497
Name:PETTIT, LINDSAY F (CNM, RNP)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:F
Last Name:PETTIT
Suffix:
Gender:F
Credentials:CNM, RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 WHIPPLE AVE
Mailing Address - Street 2:#135
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94062-2843
Mailing Address - Country:US
Mailing Address - Phone:650-366-5594
Mailing Address - Fax:650-366-6352
Practice Address - Street 1:2900 WHIPPLE AVE
Practice Address - Street 2:#135
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062-2843
Practice Address - Country:US
Practice Address - Phone:650-366-5594
Practice Address - Fax:650-366-6352
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4948174400000X
CA218367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA812OtherNURSE MIDWIFE CERT #
CA4948OtherNP CERT #
CA336037OtherRN CERT #