Healthcare Provider Details

I. General information

NPI: 1891594370
Provider Name (Legal Business Name): LINDSEY MARIE KARGBO FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2025
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6520 TRENTLAND PARK DR
ABERDEEN WA
98520-7947
US

IV. Provider business mailing address

6520 TRENTLAND PARK DR
ABERDEEN WA
98520-7947
US

V. Phone/Fax

Practice location:
  • Phone: 360-292-8690
  • Fax:
Mailing address:
  • Phone: 360-292-8690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60285069
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP.AP.70166485-NP
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: