Healthcare Provider Details

I. General information

NPI: 1346159738
Provider Name (Legal Business Name): LYNDSEY KOLL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19625 WISCHMEIER AVE
LINCOLN MO
65338-2363
US

IV. Provider business mailing address

19625 WISCHMEIER AVE
LINCOLN MO
65338-2363
US

V. Phone/Fax

Practice location:
  • Phone: 660-723-3481
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2023030309
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: