Healthcare Provider Details

I. General information

NPI: 1003354507
Provider Name (Legal Business Name): LINDSEY BRADSHAW PETERSON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSEY MARIE BRADSHAW

II. Dates (important events)

Enumeration Date: 02/03/2017
Last Update Date: 02/12/2025
Certification Date: 02/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13430 N MERIDIAN ST STE 275
CARMEL IN
46032-1484
US

IV. Provider business mailing address

13430 N MERIDIAN ST STE 275
CARMEL IN
46032-1484
US

V. Phone/Fax

Practice location:
  • Phone: 317-582-8810
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number10002209A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: