Provider Demographics
NPI:1396924411
Name:SMITH, LINDSAY NICOLE (RPA-C)
Entity type:Individual
Prefix:MS
First Name:LINDSAY
Middle Name:NICOLE
Last Name:SMITH
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:LINDSAY NICOLE
Other - Middle Name:
Other - Last Name:OLSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:250 HUFF DRIVE
Mailing Address - Street 2:JOHNSTON PAIN MANAGEMENT
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-7325
Mailing Address - Country:US
Mailing Address - Phone:910-353-4414
Mailing Address - Fax:910-353-2972
Practice Address - Street 1:250 HUFF DR
Practice Address - Street 2:JOHNSTON PAIN MANAGEMENT
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-7369
Practice Address - Country:US
Practice Address - Phone:910-353-4414
Practice Address - Fax:910-353-2972
Is Sole Proprietor?:No
Enumeration Date:2007-10-25
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-01058363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant