Provider Demographics
NPI:1396264396
Name:DAVIS, LINDSEY ELIZABETH (PNP-PC)
Entity type:Individual
Prefix:MISS
First Name:LINDSEY
Middle Name:ELIZABETH
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4134 FOXMOOR DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-7848
Mailing Address - Country:US
Mailing Address - Phone:270-922-6293
Mailing Address - Fax:
Practice Address - Street 1:2607 W ARROWOOD RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-6134
Practice Address - Country:US
Practice Address - Phone:704-588-0232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-12
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5009870363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100619570Medicaid