Provider Demographics
NPI:1821604885
Name:CALLAHAN, LINDSAY J (NP)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:J
Last Name:CALLAHAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13900 BUCK RUB DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-6111
Mailing Address - Country:US
Mailing Address - Phone:804-868-8209
Mailing Address - Fax:
Practice Address - Street 1:13900 BUCK RUB DR
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-6111
Practice Address - Country:US
Practice Address - Phone:804-868-8209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024179528363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily