Provider Demographics
NPI:1861499360
Name:PIERCE, LINDSAY R (PA-C)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:R
Last Name:PIERCE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 OXEN LN
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:66839-9127
Mailing Address - Country:US
Mailing Address - Phone:620-364-8831
Mailing Address - Fax:620-364-4111
Practice Address - Street 1:1550 OXEN LN
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:KS
Practice Address - Zip Code:66839-9127
Practice Address - Country:US
Practice Address - Phone:620-364-8831
Practice Address - Fax:620-364-4111
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-00929363AS0400X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
103241OtherBCBS OF KS
KS200003470AMedicaid
KS15-00929OtherSTATE LICENSE
P00078206OtherRAILROAD MEDICARE
103241Medicare PIN