Healthcare Provider Details

I. General information

NPI: 1205608577
Provider Name (Legal Business Name): LINDSAY KATHERINE GARMON CNP, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2023
Last Update Date: 10/30/2023
Certification Date: 10/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 WINDISH DR
GALESBURG IL
61401-9780
US

IV. Provider business mailing address

3808 W VINTON AVE
PEORIA IL
61615-2972
US

V. Phone/Fax

Practice location:
  • Phone: 309-344-2323
  • Fax:
Mailing address:
  • Phone: 815-245-6901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number209028600
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: