Provider Demographics
NPI:1851911010
Name:HACK, LINDSAY (DNP, FNP)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:HACK
Suffix:
Gender:F
Credentials:DNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 1/2 STATE ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-3104
Mailing Address - Country:US
Mailing Address - Phone:812-987-9622
Mailing Address - Fax:
Practice Address - Street 1:9880 ANGIES WAY STE 330
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-2852
Practice Address - Country:US
Practice Address - Phone:502-588-3650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-17
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3013969363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily