Provider Demographics
NPI:1982008090
Name:STRICKHOUSER, LYDIA MARTIN (APRN-C)
Entity Type:Individual
Prefix:MRS
First Name:LYDIA
Middle Name:MARTIN
Last Name:STRICKHOUSER
Suffix:
Gender:F
Credentials:APRN-C
Other - Prefix:MS
Other - First Name:LYDIA
Other - Middle Name:
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:2995 DREW ST FL 2
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-3012
Mailing Address - Country:US
Mailing Address - Phone:727-532-1355
Mailing Address - Fax:813-635-2613
Practice Address - Street 1:10141 BIG BEND RD STE 103
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-7421
Practice Address - Country:US
Practice Address - Phone:813-302-8740
Practice Address - Fax:813-605-6060
Is Sole Proprietor?:No
Enumeration Date:2014-10-17
Last Update Date:2023-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9389388363LP2300X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL105564400Medicaid