Provider Demographics
NPI:1932601630
Name:WHEATLEY, LINDSEY MICHELLE (NNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:MICHELLE
Last Name:WHEATLEY
Suffix:
Gender:F
Credentials:NNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 W 4TH ST
Mailing Address - Street 2:DEPARTMENT OF PEDIATRICS
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79763-4368
Mailing Address - Country:US
Mailing Address - Phone:432-703-5310
Mailing Address - Fax:
Practice Address - Street 1:500 W 4TH STREET
Practice Address - Street 2:NICU
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761
Practice Address - Country:US
Practice Address - Phone:432-640-1725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-08
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-APRN-LIC-197931363LN0000X
TXAP136910363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal