Provider Demographics
NPI:1780088641
Name:MARX, LINDSAY MALLEN (NP)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:MALLEN
Last Name:MARX
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:ELIZABETH
Other - Last Name:MALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:4519 HIXSON PIKE
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343
Mailing Address - Country:US
Mailing Address - Phone:423-877-4591
Mailing Address - Fax:423-877-4225
Practice Address - Street 1:4519 HIXSON PIKE
Practice Address - Street 2:
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343
Practice Address - Country:US
Practice Address - Phone:423-877-4591
Practice Address - Fax:423-877-4225
Is Sole Proprietor?:No
Enumeration Date:2014-10-21
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN18810363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner