Healthcare Provider Details

I. General information

NPI: 1386408433
Provider Name (Legal Business Name): LINDSEY ALLEN MINSHEW APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSEY MARIE ALLEN

II. Dates (important events)

Enumeration Date: 02/09/2024
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 RANCHERA ST NW
LIVE OAK FL
32064-4866
US

IV. Provider business mailing address

23476 NW 186TH AVE
HIGH SPRINGS FL
32643-0673
US

V. Phone/Fax

Practice location:
  • Phone: 386-364-1751
  • Fax:
Mailing address:
  • Phone: 386-454-0698
  • Fax: 386-454-0690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number11031207
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11031207
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9536865
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: