Healthcare Provider Details
I. General information
NPI: 1790065647
Provider Name (Legal Business Name): LINDSAY BROWN PAINTER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/24/2011
Last Update Date: 08/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3100 DURALEIGH RD SUITE 100
RALEIGH NC
27612-8106
US
IV. Provider business mailing address
120 WILLIAM PENN PLZ
DURHAM NC
27704-2150
US
V. Phone/Fax
- Phone: 919-788-8797
- Fax: 919-788-8798
- Phone: 919-220-5255
- Fax: 919-313-1276
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 5005273 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: