Provider Demographics
NPI:1669195855
Name:PENSON, LINDSEY MICHELLE (RN, BSN)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:MICHELLE
Last Name:PENSON
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5918 N MILANO CT
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-7374
Mailing Address - Country:US
Mailing Address - Phone:602-576-3607
Mailing Address - Fax:
Practice Address - Street 1:5918 N MILANO CT
Practice Address - Street 2:
Practice Address - City:LITCHFIELD PARK
Practice Address - State:AZ
Practice Address - Zip Code:85340-7374
Practice Address - Country:US
Practice Address - Phone:602-576-3607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-22
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ234237163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ163WC1500XMedicaid