Healthcare Provider Details

I. General information

NPI: 1366303562
Provider Name (Legal Business Name): LINDSEY DYKEMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2025
Last Update Date: 11/19/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 TATE SPRINGS RD
LYNCHBURG VA
24501-1109
US

IV. Provider business mailing address

1519 CLUB TER
LYNCHBURG VA
24503-2507
US

V. Phone/Fax

Practice location:
  • Phone: 434-942-3963
  • Fax:
Mailing address:
  • Phone: 434-942-3963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001303871
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: