Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 71004936A | IN |
NPI | 1083029474 |
---|---|
Provider Name | Lindsey M Addington |
First Address | Indianapolis, IN 46250-2890 |
Second Address | Indianapolis, IN 46250-2042 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2014 |
Last Update Date | 29/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000882364 | ANTHEM (01) | IN |
201235790 | (05) | IN |
4182998 | AETNA (01) | IN |
P01347649 | MEDICARE RR (01) | IN |
P01751201 | RR MEDICARE (01) | IN |