Provider Demographics
NPI:1932888559
Name:JOHNSON, LINDSEY (RN, SANE)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:RN, SANE
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:
Other - Last Name:KNIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:138 LEADER AVE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40508-3215
Mailing Address - Country:US
Mailing Address - Phone:859-218-6727
Mailing Address - Fax:
Practice Address - Street 1:138 LEADER AVE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-3215
Practice Address - Country:US
Practice Address - Phone:859-218-6727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2080C0008X
KY1148314163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
No2080C0008XAllopathic & Osteopathic PhysiciansPediatricsChild Abuse Pediatrics