Healthcare Provider Details

I. General information

NPI: 1093217929
Provider Name (Legal Business Name): LYNDSEY GIVENS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2018
Last Update Date: 08/22/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 SPRING GARDEN STREET GREENSBORO, NC 27412
GREENSBORO NC
27407
US

IV. Provider business mailing address

15 COBBLE LN
GREENSBORO NC
27407-4196
US

V. Phone/Fax

Practice location:
  • Phone: 336-334-5000
  • Fax:
Mailing address:
  • Phone: 843-618-8087
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number17-45494
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: