Healthcare Provider Details

I. General information

NPI: 1245754118
Provider Name (Legal Business Name): LYNDSEY GOODSON JONES FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2017
Last Update Date: 08/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 NW COMMERCE DR
LAKE CITY FL
32055-4709
US

IV. Provider business mailing address

148 SW LOTUS GLN
LAKE CITY FL
32024-6738
US

V. Phone/Fax

Practice location:
  • Phone: 386-719-9000
  • Fax:
Mailing address:
  • Phone: 386-344-7806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9310140
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: