Healthcare Provider Details

I. General information

NPI: 1386167393
Provider Name (Legal Business Name): LINDSEY MARIE DUCHESNE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2017
Last Update Date: 02/21/2024
Certification Date: 02/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 EASTERN AVE
BALTIMORE MD
21224-2734
US

IV. Provider business mailing address

2002 MEDICAL PKWY STE 500
ANNAPOLIS MD
21401-3268
US

V. Phone/Fax

Practice location:
  • Phone: 410-550-5018
  • Fax:
Mailing address:
  • Phone: 410-573-6480
  • Fax: 410-573-9413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC06665
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: