Healthcare Provider Details

I. General information

NPI: 1285570069
Provider Name (Legal Business Name): LINDSAY ANN LYDLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSAY ANN LAVENDER RN

II. Dates (important events)

Enumeration Date: 04/25/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 HOSPITAL LN STE 200
DANVILLE IN
46122-1998
US

IV. Provider business mailing address

1000 E MAIN ST
DANVILLE IN
46122-1948
US

V. Phone/Fax

Practice location:
  • Phone: 317-745-3366
  • Fax: 317-745-8528
Mailing address:
  • Phone: 317-837-5566
  • Fax: 317-718-6793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71018197A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: