Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 209013879 | IL |
NPI | 1003276189 |
---|---|
Provider Name | Lindsey Ostermeier |
First Address | Springfield, IL 62707-8801 |
Second Address | Springfield, IL 62707-8801 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2016 |
Last Update Date | 02/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F0116224 | AANP CERTIFICATION (01) |