Healthcare Provider Details

I. General information

NPI: 1730942095
Provider Name (Legal Business Name): LINDSEY DAWN SPIVEY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2024
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 E MARKET ST STE 301
LOUISVILLE KY
40206-1874
US

IV. Provider business mailing address

PO BOX 776879
CHICAGO IL
60677-1901
US

V. Phone/Fax

Practice location:
  • Phone: 502-629-3099
  • Fax: 502-629-3096
Mailing address:
  • Phone: 502-588-9490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number1142940
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4028992
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: