Healthcare Provider Details

I. General information

NPI: 1174344196
Provider Name (Legal Business Name): LINDSEY NICOLE MIDDLETON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2024
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 AIRWAYS BLVD BLDG B
SOUTHAVEN MS
38671-4116
US

IV. Provider business mailing address

352 W NORTHFIELD BLVD STE 3
MURFREESBORO TN
37129-5004
US

V. Phone/Fax

Practice location:
  • Phone: 844-893-0012
  • Fax: 615-278-3355
Mailing address:
  • Phone: 844-893-0012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number906867
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: