Healthcare Provider Details

I. General information

NPI: 1255449062
Provider Name (Legal Business Name): LINDSAY YOUNG SMITH D.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3867 ROSWELL RD NE STE 100
ATLANTA GA
30342-4452
US

IV. Provider business mailing address

114 LITTLE RIVER DR
WOODSTOCK GA
30188-2810
US

V. Phone/Fax

Practice location:
  • Phone: 678-821-2828
  • Fax:
Mailing address:
  • Phone: 310-922-8251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP16139
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN153159
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: