Provider Demographics
NPI:1790930709
Name:MARTIN, LINDSAY ANN (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:ANN
Last Name:MARTIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MISS
Other - First Name:LINDSAY
Other - Middle Name:ANN
Other - Last Name:ERICKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 15242
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4047
Mailing Address - Country:US
Mailing Address - Phone:270-575-1010
Mailing Address - Fax:270-575-1007
Practice Address - Street 1:2670 NEW HOLT RD STE C
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-7506
Practice Address - Country:US
Practice Address - Phone:270-575-1010
Practice Address - Fax:270-575-1007
Is Sole Proprietor?:No
Enumeration Date:2008-11-19
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3005833363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000790196OtherANTHEM BCBS