Provider Demographics
NPI:1124776877
Name:DEL MASTRO, LINDSAY STAILEY (PA-C)
Entity type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:STAILEY
Last Name:DEL MASTRO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7190 S HUDSON CIR
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2553
Mailing Address - Country:US
Mailing Address - Phone:303-548-8307
Mailing Address - Fax:
Practice Address - Street 1:721 19TH ST RM 275
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-2515
Practice Address - Country:US
Practice Address - Phone:720-462-4222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0002748363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical