Healthcare Provider Details

I. General information

NPI: 1255007357
Provider Name (Legal Business Name): LINDSEY DOLEZAL KOACH DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSEY MARIE DOLEZAL

II. Dates (important events)

Enumeration Date: 08/18/2021
Last Update Date: 08/18/2021
Certification Date: 08/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1830 LAKESIDE DR
FRANKLIN NC
28734-6778
US

IV. Provider business mailing address

PO BOX 2428
CASHIERS NC
28717-2428
US

V. Phone/Fax

Practice location:
  • Phone: 828-349-2085
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number5014876
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: