Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 152W00000X | Optometrist | 1675DT | KY |
Y | 152W00000X | Optometrist | 2676 | TN |
NPI | 1013014539 |
---|---|
Provider Name | Mrs. Lindsay K Mckinley |
First Address | Ferguson, KY 42533-0306 |
Second Address | Oneida, TN 37841-6283 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2006 |
Last Update Date | 03/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01231198 | AMERIGROUP (01) | |
3946965 | (05) | TN |
4159461 | TENNCARE/BLUECARE/BCBSTN (01) | TN |
7100010450 | (05) | KY |
7100212600 | (05) | KY |
PO0735672 | RAILROAD MEDICARE FOR ONEIDA (01) | |
V10604 | (02) |