Healthcare Provider Details

I. General information

NPI: 1811630288
Provider Name (Legal Business Name): LINDSY RENEE MEANS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2022
Last Update Date: 10/03/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 COLISEUM DR
HAMPTON VA
23666-5963
US

IV. Provider business mailing address

2 WIDGEON CT
SMITHFIELD VA
23430-1637
US

V. Phone/Fax

Practice location:
  • Phone: 304-282-1772
  • Fax:
Mailing address:
  • Phone: 304-282-1772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number86207
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number0024185378
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: