Provider Demographics
NPI:1821664954
Name:FRADY, LINDSAY DIANE (APRN FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:DIANE
Last Name:FRADY
Suffix:
Gender:F
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33325-6382
Mailing Address - Country:US
Mailing Address - Phone:954-815-8003
Mailing Address - Fax:
Practice Address - Street 1:550 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33325-6382
Practice Address - Country:US
Practice Address - Phone:954-815-8003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-30
Last Update Date:2021-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11008895363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner