Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 0024178849 | VA |
N | 363LF0000X | Nurse Practitioner - Family Medicine | R208635 | MD |
NPI | 1003392606 |
---|---|
Provider Name | Lindsey Stanton |
First Address | Fairfax, VA 22030-2888 |
Second Address | Fairfax, VA 22030-2888 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2018 |
Last Update Date | 28/08/2020 |