Healthcare Provider Details

I. General information

NPI: 1508774035
Provider Name (Legal Business Name): LINDSAY MARIE VITALE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1202 S TYLER ST
COVINGTON LA
70433-2330
US

IV. Provider business mailing address

1202 S TYLER ST
COVINGTON LA
70433-2330
US

V. Phone/Fax

Practice location:
  • Phone: 985-898-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number248648
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: