Healthcare Provider Details

I. General information

NPI: 1225890361
Provider Name (Legal Business Name): LINDSEY MARIE GEORGE CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2024
Last Update Date: 01/24/2024
Certification Date: 01/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4225 VICKERS DR
COLUMBUS IN
47203-4649
US

IV. Provider business mailing address

1904 GLENMOOR CT
COLUMBUS IN
47201-8016
US

V. Phone/Fax

Practice location:
  • Phone: 812-379-9524
  • Fax:
Mailing address:
  • Phone: 812-390-5748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number28251628A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: