Healthcare Provider Details

I. General information

NPI: 1629619325
Provider Name (Legal Business Name): LINDSEY G STEPHENS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSEY THOMPSON NP

II. Dates (important events)

Enumeration Date: 10/03/2019
Last Update Date: 12/23/2024
Certification Date: 12/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 CLINTON PKWY
CLINTON MS
39056-4730
US

IV. Provider business mailing address

965 RIDGE LAKE BLVD STE 103
MEMPHIS TN
38120-9446
US

V. Phone/Fax

Practice location:
  • Phone: 601-924-9005
  • Fax: 601-973-1622
Mailing address:
  • Phone:
  • Fax: 901-227-8591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number903375
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: