Healthcare Provider Details

I. General information

NPI: 1851801468
Provider Name (Legal Business Name): LINDSAY ANNE STUBBS CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSAY ANNE KOSER

II. Dates (important events)

Enumeration Date: 10/09/2017
Last Update Date: 07/28/2020
Certification Date: 07/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HEALTH PARK BLVD STE 3002
ST AUGUSTINE FL
32086-3703
US

IV. Provider business mailing address

300 HEALTH PARK BLVD STE 3002
ST AUGUSTINE FL
32086-3703
US

V. Phone/Fax

Practice location:
  • Phone: 904-819-1500
  • Fax: 904-810-1023
Mailing address:
  • Phone: 904-819-1500
  • Fax: 904-810-1023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPRN11007047
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: