Healthcare Provider Details

I. General information

NPI: 1053039008
Provider Name (Legal Business Name): LINDSAY LEONARD FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2022
Last Update Date: 08/29/2022
Certification Date: 08/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

972 N 600 E
SPANISH FORK UT
84660-1306
US

IV. Provider business mailing address

972 N 600 E
SPANISH FORK UT
84660-1306
US

V. Phone/Fax

Practice location:
  • Phone: 385-265-6060
  • Fax:
Mailing address:
  • Phone: 385-265-6060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12972845-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: