Provider Demographics
NPI:1912184714
Name:LINDSAY, TA'NEKA C (APRN)
Entity Type:Individual
Prefix:
First Name:TA'NEKA
Middle Name:C
Last Name:LINDSAY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:TA'NEKA
Other - Middle Name:C
Other - Last Name:VADEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:2001 NEWBURG RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-1863
Mailing Address - Country:US
Mailing Address - Phone:502-272-7101
Mailing Address - Fax:
Practice Address - Street 1:2001 NEWBURG RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-1863
Practice Address - Country:US
Practice Address - Phone:502-272-7101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-24
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3005483363LW0102X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100252080Medicaid
KY7100252080Medicaid