Healthcare Provider Details

I. General information

NPI: 1730515834
Provider Name (Legal Business Name): LINDSEY M MCCARTHY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2013
Last Update Date: 07/26/2023
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15945 CLAYTON RD STE 120
BALLWIN MO
63011-2490
US

IV. Provider business mailing address

15945 CLAYTON RD STE 120
BALLWIN MO
63011-2490
US

V. Phone/Fax

Practice location:
  • Phone: 636-256-5000
  • Fax: 636-256-5100
Mailing address:
  • Phone: 636-256-5000
  • Fax: 636-256-5100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2013029020
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: