Provider Demographics
NPI:1780824839
Name:KIDD, LINDSEY BEWICK (ACNP)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:BEWICK
Last Name:KIDD
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 POINT NORTH PL
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-2644
Mailing Address - Country:US
Mailing Address - Phone:706-272-4127
Mailing Address - Fax:
Practice Address - Street 1:302 POINT NORTH PL
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-2644
Practice Address - Country:US
Practice Address - Phone:706-272-4127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-03
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000014010363LA2100X
GARN237390363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care