Provider Demographics
NPI:1184969057
Name:BAUMAN, LINDSEY NICOLE (CPNP-PC, PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:NICOLE
Last Name:BAUMAN
Suffix:
Gender:F
Credentials:CPNP-PC, PMHNP-BC
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:NICOLE
Other - Last Name:FOWLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1171 MARKET ST STE 201
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-6514
Mailing Address - Country:US
Mailing Address - Phone:419-297-3657
Mailing Address - Fax:
Practice Address - Street 1:1171 MARKET ST STE 201
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-6514
Practice Address - Country:US
Practice Address - Phone:419-297-3657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-04
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5007793363LP0200X
OHRN.370675-COA1363LP0200X
OHRX. 15791-EX1363LP0200X
SC19522363LP0200X, 363LP0808X
OHCOA.15791-NP363LP0200X
HI4306-0363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0102093Medicaid
OH0102093Medicaid