Provider Demographics
NPI:1811781602
Name:CARRUTHERS, LYNDSIE RENAE (LPN)
Entity type:Individual
Prefix:
First Name:LYNDSIE
Middle Name:RENAE
Last Name:CARRUTHERS
Suffix:
Gender:
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 251
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43115-0251
Mailing Address - Country:US
Mailing Address - Phone:740-497-0515
Mailing Address - Fax:
Practice Address - Street 1:10881 3RD ST
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:OH
Practice Address - Zip Code:43115-7508
Practice Address - Country:US
Practice Address - Phone:740-773-1141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH194305164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse