Provider Demographics
NPI:1750278818
Name:LINDSEY, JAKOB ELI (BSN RN)
Entity type:Individual
Prefix:MR
First Name:JAKOB
Middle Name:ELI
Last Name:LINDSEY
Suffix:
Gender:M
Credentials:BSN RN
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Other - Credentials:
Mailing Address - Street 1:624 ARIZONA BLVD
Mailing Address - Street 2:
Mailing Address - City:THREE RIVERS
Mailing Address - State:MI
Mailing Address - Zip Code:49093-8603
Mailing Address - Country:US
Mailing Address - Phone:219-771-7107
Mailing Address - Fax:
Practice Address - Street 1:624 ARIZONA BLVD
Practice Address - Street 2:
Practice Address - City:THREE RIVERS
Practice Address - State:MI
Practice Address - Zip Code:49093-8603
Practice Address - Country:US
Practice Address - Phone:219-771-7107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-21
Last Update Date:2025-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704395115363LC0200X
IN28250048A163WC0200X
CA95262310163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine