Provider Demographics
NPI:1780830661
Name:KELLEY, LINDSAY D (LPN)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:D
Last Name:KELLEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8126 HORNER HILL DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45133-7135
Mailing Address - Country:US
Mailing Address - Phone:937-364-6938
Mailing Address - Fax:937-364-6938
Practice Address - Street 1:8126 HORNER HILL DR
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OH
Practice Address - Zip Code:45133-7135
Practice Address - Country:US
Practice Address - Phone:937-364-6938
Practice Address - Fax:937-364-6938
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN125923164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse