Provider Demographics
NPI:1255740072
Name:BURGESS, LINDSAY (CNM)
Entity type:Individual
Prefix:MS
First Name:LINDSAY
Middle Name:
Last Name:BURGESS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3211 W 20TH ST STE D
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-6566
Mailing Address - Country:US
Mailing Address - Phone:970-716-1173
Mailing Address - Fax:972-962-9602
Practice Address - Street 1:3211 W 20TH ST STE D
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-6566
Practice Address - Country:US
Practice Address - Phone:970-716-1173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-06
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.0183657163W00000X
COAPN.0991337-CNM367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO43535208Medicaid
CO384531YLB8Medicare PIN