Provider Demographics
NPI:1841974128
Name:LACKEY, LINDSEY (FNP-BC)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:LACKEY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PHYSICIANS WAY STE 330
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37090-8103
Mailing Address - Country:US
Mailing Address - Phone:615-449-6222
Mailing Address - Fax:
Practice Address - Street 1:100 PHYSICIANS WAY STE 330
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37090-8103
Practice Address - Country:US
Practice Address - Phone:615-449-6222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2025-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN34271363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily