Provider Demographics
NPI:1881188183
Name:HOUGHTON, LINDSAY PICCILLO (NP)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:PICCILLO
Last Name:HOUGHTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:P
Other - Last Name:BULMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 7068
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23707-0068
Mailing Address - Country:US
Mailing Address - Phone:757-686-3508
Mailing Address - Fax:757-686-0541
Practice Address - Street 1:725 VOLVO PKWY
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320
Practice Address - Country:US
Practice Address - Phone:757-548-0076
Practice Address - Fax:757-548-1652
Is Sole Proprietor?:No
Enumeration Date:2018-06-20
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001228945163W00000X
VA0024176218363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse