Healthcare Provider Details

I. General information

NPI: 1386032126
Provider Name (Legal Business Name): DAVID BURT LINDSAY RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DAVE BURT LINDSAY PMHNP-BC

II. Dates (important events)

Enumeration Date: 01/01/2015
Last Update Date: 02/17/2021
Certification Date: 01/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9414 N CANYON HEIGHTS DR
CEDAR HILLS UT
84062-8812
US

IV. Provider business mailing address

9414 N CANYON HEIGHTS DR
CEDAR HILLS UT
84062-8812
US

V. Phone/Fax

Practice location:
  • Phone: 801-822-7725
  • Fax:
Mailing address:
  • Phone: 801-822-7725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number370610-3102
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number370610-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: