Healthcare Provider Details

I. General information

NPI: 1861499360
Provider Name (Legal Business Name): LINDSAY R. PIERCE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2005
Last Update Date: 10/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 OXEN LN
BURLINGTON KS
66839-9127
US

IV. Provider business mailing address

1550 OXEN LN
BURLINGTON KS
66839-9127
US

V. Phone/Fax

Practice location:
  • Phone: 620-364-8831
  • Fax: 620-364-4111
Mailing address:
  • Phone: 620-364-8831
  • Fax: 620-364-4111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number15-00929
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: