Provider Demographics
NPI:1134906977
Name:MATTIE, LINDSEY (M(ASCP))
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:MATTIE
Suffix:
Gender:F
Credentials:M(ASCP)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12117 BANNOCK ST APT A
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-2110
Mailing Address - Country:US
Mailing Address - Phone:303-217-6488
Mailing Address - Fax:
Practice Address - Street 1:12117 BANNOCK ST APT A
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234-2110
Practice Address - Country:US
Practice Address - Phone:303-217-6488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6947207ZM0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZM0300XAllopathic & Osteopathic PhysiciansPathologyMedical Microbiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
6947OtherAMERICAN SOCIETY FOR CLINICAL PATHOLOGY