Provider Demographics
NPI:1932681756
Name:NAVARRO, LINDSAY MARIE (FNP)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:MARIE
Last Name:NAVARRO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42104 N VENTURE DR STE D118
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-3837
Mailing Address - Country:US
Mailing Address - Phone:623-505-6565
Mailing Address - Fax:623-552-3759
Practice Address - Street 1:42104 N VENTURE DR STE D118
Practice Address - Street 2:
Practice Address - City:ANTHEM
Practice Address - State:AZ
Practice Address - Zip Code:85086-3837
Practice Address - Country:US
Practice Address - Phone:623-505-6565
Practice Address - Fax:623-552-3759
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-29
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP11713363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ446406Medicaid