Healthcare Provider Details

I. General information

NPI: 1407504178
Provider Name (Legal Business Name): LINDSAY VRANCICH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2022
Last Update Date: 03/12/2022
Certification Date: 03/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1163 RED TAIL HAWK CT UNIT 6
BOARDMAN OH
44512-8010
US

IV. Provider business mailing address

1163 RED TAIL HAWK CT UNIT 6
BOARDMAN OH
44512-8010
US

V. Phone/Fax

Practice location:
  • Phone: 412-720-6235
  • Fax:
Mailing address:
  • Phone: 141-272-0623
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: