Provider Demographics
NPI:1861815599
Name:FENSTERMAKER, LINDSEY JO (RN, BSN, CCRN)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:JO
Last Name:FENSTERMAKER
Suffix:
Gender:F
Credentials:RN, BSN, CCRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10909 246TH ST NE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-8108
Mailing Address - Country:US
Mailing Address - Phone:425-870-9923
Mailing Address - Fax:
Practice Address - Street 1:10909 246TH ST NE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-8108
Practice Address - Country:US
Practice Address - Phone:425-870-9923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-31
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00166011163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA599245OtherPAYEE NUMBER