Provider Demographics
NPI:1861836769
Name:DERNIER, LINDSAY MARIE (STNA)
Entity Type:Individual
Prefix:MISS
First Name:LINDSAY
Middle Name:MARIE
Last Name:DERNIER
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1467 COLBURN ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43609-2907
Mailing Address - Country:US
Mailing Address - Phone:419-290-1072
Mailing Address - Fax:
Practice Address - Street 1:1467 COLBURN ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43609-2907
Practice Address - Country:US
Practice Address - Phone:419-290-1072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-22
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401451711012376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide