Provider Demographics
NPI:1013207778
Name:DUTLER, LINDSEY RENEE (NP-C)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:RENEE
Last Name:DUTLER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 COOK ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51103-3707
Mailing Address - Country:US
Mailing Address - Phone:712-224-7223
Mailing Address - Fax:
Practice Address - Street 1:309 COOK ST
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51103-3707
Practice Address - Country:US
Practice Address - Phone:712-224-7223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-14
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111236363LF0000X
IAA123252363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily