Healthcare Provider Details

I. General information

NPI: 1235677113
Provider Name (Legal Business Name): LINDSEY MEARS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2017
Last Update Date: 08/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 STEVENS CREEK RD
AUGUSTA GA
30907-9251
US

IV. Provider business mailing address

840 STEVENS CREEK RD
AUGUSTA GA
30907-9251
US

V. Phone/Fax

Practice location:
  • Phone: 706-722-6957
  • Fax: 706-396-6357
Mailing address:
  • Phone: 706-722-6957
  • Fax: 706-396-6357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number192466
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: