Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | OS017207 | PA |
NPI | 1003160714 |
---|---|
Provider Name | Dr. Lindsi Anne Dearment |
First Address | Lancaster, PA 17601-4144 |
Second Address | Lancaster, PA 17601-4144 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2012 |
Last Update Date | 19/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1030254810001 | (05) | PA |