Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 201707978NP-PP | OR |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 201707978NP-PP | OR |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 9296007 | FL |
NPI | 1003291147 |
---|---|
Provider Name | Lindsey Wilson |
First Address | Eugene, OR 97405-3866 |
Second Address | Eugene, OR 97405-3866 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2015 |
Last Update Date | 08/11/2021 |