Healthcare Provider Details

I. General information

NPI: 1578018057
Provider Name (Legal Business Name): LINDSAY MCKINNEY MS, LAT, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2016
Last Update Date: 04/06/2025
Certification Date: 04/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 E OLIVE ST
GREENCASTLE IN
46135
US

IV. Provider business mailing address

312 WAYSIDE DR
PLAINFIELD IN
46168-1781
US

V. Phone/Fax

Practice location:
  • Phone: 317-509-0439
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number36002977A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: