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NPI Code Detail

MEDICARE: LINDSEY PARKS-PLAZA

MEDICARE: LINDSEY PARKS-PLAZA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner4704300169NSA2206IMI

General Provider Information

NPI Number : 1942957824
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDSEY PARKS-PLAZA
Provider Business Mailing Address
First Line : PO BOX 746723
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6723
Country : US
Telephone Number : 312-733-9730
Fax Number :
Provider Business Practice Location Address
First Line : 26390 GRATIOT AVE
Second Line :
City : ROSEVILLE
State : MI
Zip : 48066-5106
Country : US
Telephone Number : 586-315-3987
Fax Number : 586-580-7485
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2022
Last Update Date : 05/12/2025

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Directions to “ LINDSEY PARKS-PLAZA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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