Provider Demographics
NPI:1740750207
Name:DITANNA, LINDSEY TAYLOR (FNP)
Entity Type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:TAYLOR
Last Name:DITANNA
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 1:4 PARK CENTER CT STE 100
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5613
Mailing Address - Country:US
Mailing Address - Phone:410-484-8860
Mailing Address - Fax:410-484-2566
Practice Address - Street 1:4 PARK CENTER CT STE 100
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5613
Practice Address - Country:US
Practice Address - Phone:410-484-8860
Practice Address - Fax:410-484-2566
Is Sole Proprietor?:No
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR206791363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily